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=== B-cell depletion ===
=== B-cell depletion ===
* B cells are believed to have an antibody-independent effect, which may modulate regulatory T-cell immune reactions against foreign and self-antigens.
* Rituximab is an example of B-cell depletion that has been shown to improve clinical signs and symptoms of Takayasu arteritis.


=== Cytotoxic agents ===
=== Cytotoxic agents ===

Revision as of 21:31, 13 April 2018

Takayasu's arteritis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]


Overview

Medical Therapy

Medical therapy of Takayasu arteritis depends on the disease activity and the complications that develop.[1]

The two most important aspects of treatment:

  • Controlling the inflammatory process
  • Controlling hypertension

Corticosteroids

  • Corticosteroids are the mainstay of therapy for active Takayasu arteritis
  • The usual starting dose is approximately 1 milligram per kilogram of body weight per day
  • Long-term, low-dose corticosteroid therapy may be required
  • Osteoporosis prevention when patients are started on corticosteroids should be considered

IL-6 receptor inhibitor

  • Humanized monoclonal antibody tocilizumab suggested as a treatment for Takayasu arteritis through blockade of the soluble interleukin-6 (IL-6) receptor.

B-cell depletion

  • B cells are believed to have an antibody-independent effect, which may modulate regulatory T-cell immune reactions against foreign and self-antigens.
  • Rituximab is an example of B-cell depletion that has been shown to improve clinical signs and symptoms of Takayasu arteritis.

Cytotoxic agents

  • Methotrexate, azathioprine, and cyclophosphamide are
  • Used for patients whose disease is steroid resistant or relapsing
  • Continued for at least 1 year after remission and are then tapered to discontinuation

Anti-tumor necrosis factor agents

References

  1. Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE (January 1977). "Takayasu's arteritis. Clinical study of 107 cases". Am. Heart J. 93 (1): 94–103. PMID 12655.

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