Successful treatment with tocilizumab monotherapy for Takayasu arteritis developing during infliximab therapy in a patient with ulcerative colitis

Abstract

A 23-year-old female patient with ulcerative colitis (UC) who had been successfully treated with infliximab (IFX) plus 5-aminosalicylated acid (5-ASA) developed Takayasu arteritis (TAK). She refused to take glucocorticoids to treat TAK. IFX was discontinued, and 8 mg/kg of tocilizumab (TCZ) was added to 5-ASA. Her symptoms such as fever and chest pain disappeared within a week along with serum CRP. TCZ was administered every 2 weeks for 2 months and monthly thereafter. After 1-year treatment of TCZ monotherapy, arterial wall thickening also improved. In addition, UC has been in remission without any gastrointestinal symptoms. TCZ monotherapy is effective for TAK and might not compromise UC.

Keywords:

• Takayasu arteritis
• ulcerative colitis
• tocilizumab
• infliximab

Conflict of interest

KA received research grant from Chugai Pharmaceutical Co, Ltd, and honoraria from Chugai Pharmaceutical Co, Ltd, Pfizer Japan and Tanabe-Mitsubishi Pharma. Other authors have nothing to declare.