piperidines and Takayasu-Arteritis

To investigate the efficacy and safety of leflunomide (LEF) versus tofacitinib (TOF) in Takayasu arteritis (TAK) patients. Sixty-seven active patients were recruited from an ongoing observational TAK cohort, including 35 patients treated with glucocorticoids (GCs) and LEF and 32 patients treated with GCs and TOF. The observation period was 12 months. The effectiveness rate (ER), remission rate, inflammatory parameters reduction, vascular imaging changes, GCs tapering, disease relapse and side-effects were evaluated between two groups. These aspects were also assessed separately among treatment-naïve or -refractory patients. The ER at 6 and 12 months was 88.57% (31/35) vs. 87.50% (28/32) (p = 1.00) and 71.43% (25/35) vs. 71.88% (23/32) (p = 1.00) in the LEF and TOF group. The percentage of patients with persistent remission from 6th to 12th months and GCs≤7.5 mg/day at 12 months was higher in TOF group (15 (46.88%) vs. 6 (17.14%) p = 0.02). The relapse prevalence was 6 (17.14%) and 7 (21.88%) (p = 0.76), respectively. Erythrocyte sedimentation rate (ESR) was decreased significantly at 6 months in both groups (p<0.05), whereas C-reactive protein (CRP) level was reduced significantly at 6 months only in the TOF group (p = 0.007). The proportion of patients with imaging improvement was higher in the TOF group (eight (25.00%) and two (5.71%), p = 0.04). Side-effect prevalence was higher in the LEF group (11 (31.43%) vs. 3 (9.38%), p = 0.04). In conclusion, LEF and TOF were comparable for TAK treatment. TOF might be a potential agent to maintain disease remission at a low dose of glucocorticoids in TAK.

Topics: Glucocorticoids; Humans; Immunosuppressive Agents; Leflunomide; Piperidines; Prospective Studies; Pyrimidines; Recurrence; Takayasu Arteritis; Treatment Outcome

Topics: Colitis, Ulcerative; Humans; Janus Kinase Inhibitors; Piperidines; Pyrimidines; Takayasu Arteritis

Topics: Colitis, Ulcerative; Humans; Janus Kinase Inhibitors; Piperidines; Pyrimidines; Takayasu Arteritis

Topics: Colitis, Ulcerative; Humans; Piperidines; Pyrimidines; Takayasu Arteritis

Topics: Colitis, Ulcerative; Humans; Piperidines; Pyrimidines; Takayasu Arteritis

Topics: Humans; Piperidines; Pyrimidines; Takayasu Arteritis

Topics: Colitis, Ulcerative; Cytokines; HLA-B52 Antigen; Humans; Piperidines; Positron Emission Tomography Computed Tomography; Pyrimidines; Takayasu Arteritis

To compare the treatment efficacy and safety of tofacitinib (TOF) versus methotrexate (MTX) in Takayasu arteritis (TAK).. Fifty-three patients with active disease from an ongoing prospective TAK cohort in China were included in this study. Twenty-seven patients were treated with glucocorticoids (GCs) and TOF, and 26 patients were treated with GCs with MTX. The observation period was 12 months. Complete remission (CR), inflammatory parameter changes, GCs tapering and safety were assessed at the 6th, 9th and 12th month. Vascular lesions were evaluated at the 6th and 12th month, and relapse was analysed during 12 months.. The CR rate was higher in the TOF group than in the MTX group (6 months: 85.19% vs 61.54%, p=0.07; 12 months: 88.46% vs 56.52%, p=0.02). During 12 months' treatment, patients in the TOF group achieved a relatively lower relapse rate (11.54% vs 34.78%, p=0.052) and a longer median relapse-free duration (11.65±0.98 vs 10.48±2.31 months, p=0.03). Average GCs dose at the 3rd, 6th and 12th month was lower in the TOF group than that in the MTX group (p<0.05). A difference was not observed in disease improvement or disease progression on imaging between the two groups (p>0.05). Prevalence of side effects was low in both groups (3.70% vs 15.38%, p=0.19).. TOF was superior to MTX for CR induction, a tendency to prevent relapse and tapering of the GCs dose in TAK treatment. A good safety profile for TOF was also documented in patients with TAK.

Topics: Adolescent; Adult; Antirheumatic Agents; Disease Progression; Drug Therapy, Combination; Female; Glucocorticoids; Humans; Janus Kinase Inhibitors; Male; Methotrexate; Middle Aged; Piperidines; Prospective Studies; Pyrimidines; Recurrence; Takayasu Arteritis; Time Factors; Treatment Outcome; Young Adult

Topics: Adolescent; Colitis, Ulcerative; Female; Humans; Piperidines; Protein Kinase Inhibitors; Pyrimidines; Pyrroles; Takayasu Arteritis; Treatment Outcome

Topics: Adult; Colitis, Ulcerative; Female; Humans; Piperidines; Protein Kinase Inhibitors; Pyrimidines; Pyrroles; Remission Induction; Takayasu Arteritis

Topics: Adolescent; Adult; Female; Humans; Piperidines; Protein Kinase Inhibitors; Pyrimidines; Takayasu Arteritis; Young Adult

Takayasu arteritis is a rare chronic progressive panendarteritis involving the aorta and its main branches. Anesthesia in patients with this disease can be complicated by severe uncontrolled hypertension, end-organ dysfunction, and stenosis of major blood vessels. In this case, general anesthesia was induced with sevoflurane and remifentanil without complications. To prevent intraoperative complications, we conducted intubation with a rigid video laryngoscope with careful consideration of the concentrations of analgesics and sedatives used. This case demonstrates the importance of anesthetic techniques for maintaining adequate tissue perfusion without hemodynamic changes in the anesthetic management of patients with Takayasu arteritis.

Topics: Analgesics; Anesthesia, Dental; Anesthesia, General; Anesthetics, Inhalation; Anesthetics, Intravenous; Blood Pressure; Female; Heart Rate; Humans; Hypnotics and Sedatives; Intubation, Intratracheal; Laryngoscopes; Methyl Ethers; Midazolam; Molar, Third; Piperidines; Remifentanil; Sevoflurane; Takayasu Arteritis; Tooth Extraction; Video Recording; Young Adult