{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:54:09Z","timestamp":1791557649084,"version":"4.3.4"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["ZIA\u2010AR\u2010041199"],"award-info":[{"award-number":["ZIA\u2010AR\u2010041199"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Comparative, prospective data on biologics for Takayasu arteritis (TAK) are limited. We compared tumor necrosis factor inhibitors (TNFi) and tocilizumab (TCZ) in a combined cohort, assessed demographic and cytokine influences, and evaluated longitudinal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical response to TNFi or TCZ was assessed in patients with TAK from two independent cohorts. In a subset followed prospectively within a standardized research protocol, physician global assessment (PGA), C\u2010reactive protein (CRP), erythrocyte sedimentation rate (ESR), and 18F\u2010fluorodeoxyglucose positron emission tomography (FDG\u2010PET) activity were compared pretreatment and posttreatment. Time to response was analyzed using Kaplan\u2010Meier curves. Cytokine levels were measured with Luminex assays in patients and age\u2010matched healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 151 patients (cohort A\u00a0=\u00a057; cohort B\u00a0=\u00a094), 129 received TNFi and 56 received TCZ during follow\u2010up. Clinical response rates were 72.1% for TNFi and 60.7% for TCZ (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.17). In the prospective subset, no significant differences in PGA, CRP, ESR, or FDG\u2010PET outcomes (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&gt;\u20090.30) were observed. Changing to another TNFi or switching between TNFi or TCZ after treatment failure resulted in clinical response in 31 of 33 (94%) patients. TNFi responders had a younger median age at onset than nonresponders (23 vs 33.5 years,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.0039), whereas TCZ responders were older (35 vs 21.5 years,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.0043). Patients with onset &lt;30 years showed elevated interleukin\u20106 and TNF versus controls, a pattern not observed in older patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TNFi and TCZ demonstrated similar effectiveness in TAK. These findings support therapeutic switching after treatment failure and suggest that age\u2010related immunologic differences may influence treatment response.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr80169-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80169","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:03:56Z","timestamp":1790589836000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effectiveness of Tocilizumab and Tumor Necrosis Factor Inhibitors in Takayasu Arteritis: Age\u2010Related Differences in Treatment Response"],"prefix":"10.1002","author":[{"given":"Sreenidhi","family":"Sankararaman","sequence":"first","affiliation":[{"name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5440-2078","authenticated-orcid":false,"given":"Alessandro","family":"Tomelleri","sequence":"additional","affiliation":[{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6806-3794","authenticated-orcid":false,"given":"Corrado","family":"Campochiaro","sequence":"additional","affiliation":[{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana","family":"Yamamoto de Almeida","sequence":"additional","affiliation":[{"name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Bellino","sequence":"additional","affiliation":[{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Baldissera","sequence":"additional","affiliation":[{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Dagna","sequence":"additional","affiliation":[{"name":"Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Salhani","sequence":"additional","affiliation":[{"name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institutes of Health  Bethesda 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