Ab1294 Efficacy and Safety of Disease-Modifying Anti-Rheumatic Drugs in the Treatment of Takayasu Arteritis

Background: Disease-modifying anti-rheumatic drugs are used in the treatment of Takayasu arteritis, and understanding the effectiveness and safety of drugs in the treatment is crucial for guiding clinical medication. Objectives: To elucidate the efficacy and safety of disease-modifying anti-rheumatic drugs (DMARDS) used in Takayasu arteritis (TAK). Methods: Data was retrieved from database included Web of Science, Pubmed Central, Scopus, CNKI, SinoMed and WanFang Data for studies published before 20 December 2023. Studies with a sample size Results: Ninety-one studies totaling 3767 patients from 9 randomized controlled trials and 82 observational studies were identified, consisting of 15 different drugs. The main outcomes assessed included the proportion of the clinical responses, angiographic stabilization rates, the adverse event rates and the relapse rates, the changes of glucocorticoid (GC) doses and acute phase inflammation markers (CRP/ESR) after treatment analyzed by random effects model. Observational studies showed a high risk of bias. The pooled at least partial clinical remission rates of all DMARDs were 77% (95% CI:72%~81%), and the remission rates of tocilizumab and leflunomide (83%,95%CI:76%-89%;89%,95%CI:82%-94%)were highest in the biological agents and the conventional DMARDs(cDMARDs),respectively. The proportion of TAK patients achieving angiographic stabilization was 83%(95% CI:78%-88%). Among the drugs, angiographic stabilization rates of tofacitinib were high (94%,95% CI:81%-100%; two study), next was followed by methotrexate (90%, 95%CI:82%-95%). The pooled relapses rates after the treatment were 24% (95% CI:17%-31%). The relapse rate was 37% for anti-TNF agents (95% CI:19%-56%; 7 studies) and 18% for secukinumab (95% CI: 5%-40%; one study). The GC doses and CRP/ESR were significantly decreased after the treatmengt of tocilizumab and anti-TNF agents. The adverse events occurred in 21% (95% CI:15%-27%), and the rates of the cyclophosphamide is significantly high (37%,95%CI:24%-51%). Conclusion: Among the biological agents, tocilizumab and anti-TNF agents had a significant impact on outcomes in TAK,especially on decreasing GC doses and acute phase inflammation markers. Secukinumab was shown to have a low relapse rate, while the relapse rates of anti-TNF agents need to be noted. Among the cDMARDS, leflunomide had a significant effect on clinical remission.Methotrexate provides functional benefits in angiographic stabilization. Future more refined studies should attempt to include larger cohorts. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.