18F-Fluorodeoxyglucose positron emission tomography and serum cytokines and matrix metalloproteinases in the assessment of disease activity in Takayasu's arteritis

Arraes, Anne Elizabeth Diniz; Souza, Alexandre Wagner Silva de; Mariz, Henrique Ataíde; Silva, Neusa P.; Torres, I.; Barbosa, Paula Nicole Vieira Pinto; Lima, Eduardo Nóbrega Pereira; Sato, Emília Inoue

doi:10.1016/j.rbre.2015.08.007

Cited by 14 publications

(18 citation statements)

References 25 publications

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“…Serum levels of IL‐6 were demonstrated to be positively related to disease activity in several studies. Arraes et al . found that serum IL‐6 levels were significantly higher in TA patients and had a positive relationship with disease activity.…”

Section: Biomarkerssupporting

confidence: 61%

Radiology and biomarkers in assessing disease activity in Takayasu arteritis

2018

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Takayasu arteritis (TA) is a rare and chronic large-vessel vasculitis that predominantly affects aorta and its main branches. It occurs mainly in females <40 years. Precise assessment of disease activity is one of the major difficulties in the long-term management of TA. Until now, the accuracy of traditional activity index is still controversial. During these years, due to rapid development of radiological technology and researches of pathogenesis, new measurements and biomarkers have been applied to monitor disease activity for TA. Thus, in this review, we mainly discuss the benefits and limitations of recent developments of radiology and biomarkers for disease activity assessment in TA.

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Section: Biomarkerssupporting

confidence: 61%

Radiology and biomarkers in assessing disease activity in Takayasu arteritis

2018

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“…In the majority of papers, patients with active disease presented with higher ESR and CRP levels as compared with patients with stable/inactive disease (ESR ranged 5–115 mm/hour vs 1–43 mm/hour and CRP ranged 0.1–99.1 mg/dL vs 0.06–7.77 mg/dL for active vs stable disease, respectively). Nevertheless, 28.5% of patients classified as being in remission (National Institutes of Health (NIH) criteria) may present with elevated CRP and 23.8% with elevated ESR23 (overall LoE 4) 23–29…”

Section: Resultsmentioning

confidence: 99%

“…Circulating interleukin (IL)-628 31–33 and IL-1831 levels of patients with active disease tend to be higher than of those with stable, inactive disease or healthy controls. In paired samples of patients who had active disease and then evolved to a stable stage, ESR and IL-18 significantly decreased and the changes in ESR correlated well with those of serum IL-18 levels (r=0.61, p<0.001) 31.…”

Section: Resultsmentioning

confidence: 99%

Management of Takayasu arteritis: a systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis

et al. 2019

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ObjectiveTo collect available evidence on management of large vessel vasculitis to inform the 2018 update of the EULAR management recommendations.MethodsTwo independent systematic literature reviews were performed, one on diagnosis and monitoring and the other on drugs and surgical treatments. Using a predefined PICO (population, intervention, comparator and outcome) strategy, Medline, Embase and Cochrane databases were accessed. Eligible papers were reviewed and results condensed into a summary of findings table. This paper reports the main results for Takayasu arteritis (TAK).ResultsA total of 287 articles were selected. Relevant heterogeneity precluded meta-analysis. Males appear to have more complications than females. The presence of major complications, older age, a progressive disease course and a weaker inflammatory response are associated with a more unfavourable prognosis. Evidence for details on the best disease monitoring scheme was not found. High-quality evidence to guide the treatment of TAK was not found. Glucocorticoids are widely accepted as first-line treatment. Conventional immunosuppressive drugs and tumour necrosis factor inhibitors were beneficial in case series and uncontrolled studies. Tocilizumab failed the primary endpoint (time to relapse) in a randomised controlled clinical trial; however, results still favoured tocilizumab over placebo. Vascular procedures may be required, and outcome is better when performed during inactive disease.ConclusionsEvidence to guide monitoring and treatment of patients with TAK is predominantly derived from observational studies with low level of evidence. Therefore, higher-quality studies are needed in the future.

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“…Disease activity in TA can be inferred from increased levels of serum IL-6 and TNFα and a higher uptake of 18F-Fluorodeoxyglucose [(18)F-FDG] in the arterial wall (25,22); even so, distinguishing between systemic and vascular inflammation is difficult and various evaluations have been suggested towards this end: The Indian Takayasu Clinical Activity Score (12), while other authors have recommended direct imaging of vessel wall thickening (ultrasound, CT, angiogram) or positron emission tomography computerized tomography (PET CT) (11).…”

Section: Discussionmentioning

confidence: 99%

Takayasu arteritis in a patient presenting with stroke and improvement of hemiparesis following vascular bypass surgery: A case report

et al. 2020

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Takayasu arteritis (TA) is a rare disease, with an estimated incidence in general population of <1/year/million, and its presentation as a stroke is an even less common occurrence. The case presented herein is unusual for the fact that the surgical procedure was performed on an urgent basis, irrespective of the active or inactive status of the disease; the bypass technique involved multiple sites; the patient was administered an original combination of medications before and after the procedure, and the patient exhibited significant neurological improvement after the subacute period of the stroke (6 weeks after stroke, 1 week after the procedure), which was sustained at the 18-month follow-up. Published literature on bypass surgery for TA indicate that the majority of complications (aneurysms, stenosis, intracerebral hemorrhage, etc.) occur during the early stages and affect approximately one-third of patients; this procedure was also successful as the patient subsequently began recovering motor function, indicating the successful, sustained re-vascularization of the affected motor areas. Being able to restore the patient's independent activities of daily living is an important goal, which was achieved in this patient and may serve as a reference point for what is possible to achieve in these cases.

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18F-Fluorodeoxyglucose positron emission tomography and serum cytokines and matrix metalloproteinases in the assessment of disease activity in Takayasu's arteritis

Abstract: Higher serum IL-6 and TNFα levels as well as higher (18)F-FDG uptake in arterial wall are associated with active TA.

Cited by 14 publications

References 25 publications

Radiology and biomarkers in assessing disease activity in Takayasu arteritis

Radiology and biomarkers in assessing disease activity in Takayasu arteritis

Management of Takayasu arteritis: a systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis

Takayasu arteritis in a patient presenting with stroke and improvement of hemiparesis following vascular bypass surgery: A case report

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