New Therapeutic Approaches to Large-Vessel Vasculitis.

IF 15.1 1区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Annual review of medicine Pub Date : 2024-01-29 Epub Date: 2023-09-08 DOI:10.1146/annurev-med-060622-100940
Mahmut S Kaymakci, Kenneth J Warrington, Tanaz A Kermani
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Abstract

Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are large-vessel vasculitides affecting the aorta and its branches. Arterial damage from these diseases may result in ischemic complications, aneurysms, and dissections. Despite their similarities, the management of GCA and TAK differs. Glucocorticoids are used frequently but relapses are common, and glucocorticoid toxicity contributes to significant morbidity. Conventional immunosuppressive therapies can be beneficial in TAK, though their role in the management of GCA remains unclear. Tumor necrosis factor inhibitors improve remission rates and appear to limit vascular damage in TAK; these agents are not beneficial in GCA. Tocilizumab is the first biologic glucocorticoid-sparing agent approved for use in GCA and also appears to be effective in TAK. A better understanding of the pathogenesis of both conditions and the availability of targeted therapies hold much promise for future management.

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大血管炎的新治疗方法
巨细胞动脉炎(GCA)和高安动脉炎(TAK)是影响主动脉及其分支的大血管血管炎。这些疾病造成的动脉损伤可能导致缺血性并发症、动脉瘤和动脉夹层。尽管GCA和TAK有相似之处,但治疗方法却有所不同。糖皮质激素被频繁使用,但复发很常见,糖皮质激素的毒性会导致严重的发病率。传统的免疫抑制疗法对TAK有益,但其在GCA治疗中的作用仍不明确。肿瘤坏死因子抑制剂可提高缓解率,似乎还能限制TAK的血管损伤;但这些药物对GCA无益。托西珠单抗是首个获准用于GCA的生物糖皮质激素替代药物,似乎对TAK也有效。对这两种疾病的发病机制有了更深入的了解,再加上靶向疗法的出现,未来的治疗大有希望。
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来源期刊
Annual review of medicine
Annual review of medicine 医学-医学:内科
CiteScore
24.90
自引率
0.00%
发文量
58
期刊介绍: The Annual Review of Medicine, which has been published since 1950, focuses on important advancements in diverse areas of medicine. These include AIDS/HIV, cardiology, clinical pharmacology, dermatology, endocrinology/metabolism, gastroenterology, genetics, immunology, infectious disease, neurology, oncology/hematology, pediatrics, psychiatry, pulmonology, reproductive medicine, and surgery. The journal's current volume has transitioned from a gated access model to an open access model through the Annual Reviews' Subscribe to Open program. All articles published in the journal are now available under a CC BY license.
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