Biologic Therapies for the Treatment of Large Vessel Vasculitis: A Systematic Review and Meta-analysis
Siyuan Chen, Xiao Cui, Yue Chen, Xiaogang Guo
Abstract
To summarize the existing evidence from double-blind randomized controlled trials (RCTs) and cohort studies regarding the effects of biologic agents for the treatment of large vessel vasculitis.
Introduction
Large vessel vasculitis (LVV) is vasculitis with aorta and major branches involved, including two main subtypes, giant cell arteritis (GCA) and Takayasu’s arteritis (TAK). Chronic inflammation activation could lead to progressive vascular pathological and morphological changes in involved arteries, including stenosis, occlusion, dilation, aneurysm formation, and rupture, resulting in corresponding organ injuries, severe complications, or even death. So far, glucocorticoids remain the first line of treatment for GCA and TAK.
Materials and Methods:
We included studies that examined the effects of biologic therapies in patients diagnosed with TAK and GCA. Eligible study designs included RCTs and cohort studies that assessed outcomes related to glucocorticoid tapering and disease activity. The primary outcome was relapse rate during glucocorticoid tapering. Secondary outcomes included remission rates, relapse-free survival, cumulative glucocorticoid doses, glucocorticoid tapering dose and rate, and changes in markers of disease activity.
Discussion
In this systematic review and meta-analysis, we included well-designed double-blind RCTs and cohort studies regarding the effects of biologic agents for LVV, and found that biologic agents could significantly prolonging relapse-free survival, increasing glucocorticoid taper rate, and decreasing cumulative glucocorticoid dose for both GCA and TAK. The quality assessment suggested a low risk of bias for all included double-blind RCTs and moderate to serious risk of bias for the cohort studies, thus bring relatively strong evidence for reviewing the effects of biologic agents for LVV.
Citation: Chen S, Cui X, Chen Y, Guo X (2025) Biologic therapies for the treatment of large vessel vasculitis: A systematic review and meta-analysis. PLoS ONE 20(3): e0314566. https://doi.org/10.1371/journal.pone.0314566
Editor: Ritu Chakravarti, University of Toledo College of Medicine and Life Sciences, UNITED STATES OF AMERICA
Received: April 13, 2024; Accepted: November 12, 2024; Published: March 10, 2025.
Copyright: © 2025 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the manuscript and its Supporting Information files.
Funding: This work was supported by the National Natural Science Foundation of China Youth Projects [No. 81900246] to XC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
