For a pediatric patient with Takayasu arteritis with persistent enhancement and mild progression on imaging after recent transition to tocilizumab (2 months), would you continue tocilizumab therapy, increase to q2 week dosing, or transition to cyclophosphamide?

In a pediatric patient with Takayasu arteritis who recently transitioned to Tocilizumab and demonstrates persistent vascular enhancement with mild imaging progression after 2 months of therapy, what would be your next management step?

• Continue current tocilizumab regimen and reassess with interval imaging
• Escalate tocilizumab to every 2 week dosing
• Transition to cyclophosphamide
• Other