Certolizumab pegol (CZP) is a PEGylated antigen-binding fragment-fragment of a humanized mAb neutralizing TNF. It lacks Fc-fragment and has a very low potential to cross the placenta. We aimed to report the efficacy and safety of CZP in a case series of patients with refractory Takayasu arteritis (TA). Ten females of reproductive age (18-35 years) with TA were treated with CZP (at a dose of 400 mg at weeks 0, 2 and 4 and at 200 mg every 2 weeks thereafter) for a median of 10 months (range 3-28). Prior to CZP administration all patients received glucocorticoids and ± MTX, CYC, AZA, HCQ, LEF or MMF. Six patients were previously treated with other biological anti-cytokine drugs. The National Institutes of Health criteria and the Indian Takayasu Clinical Activity Score 2010 were used to define disease activity. All patients rapidly responded to treatment with CZP and were able to taper prednisone and MTX doses. Treatment with CZP resulted in a significant decrease in median serum CRP levels and normalization of Indian Takayasu Clinical Activity Score 2010 score in 9 of 10 patients. Remission of systemic vasculitis was achieved in all patients. Seven patients maintained remission for at least 4 months, while one patient developed relapse after 2 years of CZP treatment. Side effects included mild infections (n = 5). Our case series suggests that CZP may be an effective and steroid-sparing treatment option in patients with active TA even if they did not previously respond to other TNF inhibitors or tocilizumab.

Background/Objectives: Takayasu’s arteritis (TAK) is an inflammatory vascular disease, but atherosclerotic mechanisms may also contribute to vascular injury in TAK. This study aimed to evaluate the clinical and imaging characteristics of TAK patients with and without iliofemoral artery involvement on FDG-PET/CT, focusing on the association with classical atherosclerotic risk factors. Methods: Patients fulfilling the 1990 ACR classification criteria for TAK who underwent FDG-PET/CT imaging during follow-up were retrospectively analyzed. Demographic, clinical, and laboratory data were recorded, including traditional cardiovascular risk factors: diabetes, hypertension, hyperlipidemia, smoking, obesity (BMI ≥ 30 kg/m²), and family history of cardiovascular disease. PET vascular activity score (PETVAS) and visual analysis were used to assess vascular inflammation. Results: PET/CT scans of 77 TAK patients (F/M = 63/14) were evaluated. The mean age was 43.0 ± 12.9 years, and the mean disease duration was 120.1 ± 88.8 months. Iliofemoral artery involvement was observed in nine (12%) patients. Compared to those without such involvement, these patients were older (52.5 ± 17.4 vs. 41.3 ± 12.1 years, p = 0.098), more frequently male (44% vs. 6%, p = 0.015), and had higher CRP levels (38.5 mg/L vs. 10.7 mg/L, p = 0.026). Smoking (77% vs. 40%, p = 0.045) and chronic kidney disease (22% vs. 4%, p = 0.046) were also more prevalent. PET activity according to visual analysis was higher among those with iliofemoral involvement (67% vs. 27%, p = 0.015). In multivariate analysis, older age (OR = 1.07, p = 0.044) and male sex (OR = 6.68, p = 0.039) were independently associated with iliofemoral artery involvement. Conclusions: Iliofemoral artery involvement on PET/CT in TAK patients was associated with traditional atherosclerotic risk factors—particularly older age, male sex and smoking. These findings suggest that atherosclerotic mechanisms may coexist with or amplify vascular inflammation in TAK. Aggressive management of cardiovascular risk factors should therefore be emphasized in this subgroup of TAK patients.

The TReasure registry, created in 2017, is an observational multicenter cohort that includes inflammatory arthritis patients. This article reviews the methodology and objectives of the TReasure registry established to collect data from rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients. Fifteen rheumatology centers in Turkey will contribute data to the TReasure database. The actual proprietor of the database is the Hacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises. Pharmaceutical companies that operate in Turkey (in alphabetical or er), Abbvie, Amgen, BMS, Celltrion Healthcare, Novartis, Pfizer, Roche, and UCB, support the TReasure registry. TReasure is a web-based database to which users connect through a URL (https://www.trials-network.org/treasure) with their unique identifier and passwords provided for data entry and access. TReasure records demographic and clinical features, comorbidities, radiology and laboratory results, measures of disease activity, and treatment data. TReasure will provide us with various types of data, such as a cross-sectional view of the current nationwide status of the patients currently receiving these treatments, and retrospective data as much as allowed by the participating centers’ records. Finally, a high-quality prospective dataset will be built over the ensuing years from patients with a new diagnosis of RA or SpA.