Emerging drug therapies for refractory Takayasu arteritis

Adequate suppression of the inflammatory process using steroids and immunosuppressive drugs is an established strategy in the treatment of active phase of Takayasu arteritis. Methotrexate, Azathioprine, Cyclophosphamide, Mycophenolate mofetil and Tacrolimus hydrate are generally used as supplement or substitute for steroids to achieve better remission in ‘Refractory Cases’. In recent past newer biologic molecules like Anti-TNF-Alfa inhibitors, B-cell deletion agents, anti-interleukin-6 therapies and Immune-modulating agents have been tried for the management of ‘refractory’ cases with varied success; but the experience is still limited. This is a short review of possible role of each of these novel agents in management of refractory Takayasu arteritis.