Effectiveness of intravenous infliximab versus subcutaneous adalimumab in Takayasu arteritis: multicenter retrospective study.

In this large multicentre study, we aimed to compare the effectiveness of intravenous infliximab vs subcutaneous adalimumab in patients with Takayasu arteritis. We conducted a retrospective multicentre study across referral centers in France, Italy, Spain, Armenia, Israel, Japan, Tunisia, and Russia, analyzing biological-targeted therapies in TAK from January 2017 to September 2019. A total of 135 TAK patients who received adalimumab (n = 34) or infliximab (n = 101) for at least 3 months were included. Baseline demographics, TAK characteristics, and concurrent treatments were comparable, except for a higher rate of Numano type V in adalimumab group. At 6 months, 71% achieved complete response (NIH < 2 with <7.5 mg/day prednisone), including 68% on adalimumab and 73% on infliximab (p= 0.8). The factors associated with complete response to TNFα inhibitors at 6 months in univariate analysis were age < 30 years, tobacco use, vascular signs at the biologic initiation, NIH ≥ 2, CRP> 20 mg/l, a starting dose >20 mg/day of prednisone, but not the use of infliximab or either adalimumab. The cumulative incidence of treatment failure was not significantly different between infliximab and adalimumab patients. During the median follow-up of 23 months [Q1: 17; Q3:42] and 48 [25; 99] in patients who received IV infliximab and SC adalimumab, respectively, the risk of relapse at 12 months was at 10.9% [0, 21.9] and 16.8% [8.64, 24.27], respectively. The overall incidence of revascularizations was not significantly different. In this study, we confirm that infliximab and adalimumab are both effective in TAK, without significant differences in the risk of relapse and revascularizations.