SAT0364 Pentraxin 3 as Biomarker in Assessment of Disease Activity in Takayasu Arteritis

Devarasetti, Phani Kumar; Appani, S.K.; Irlapati, Rajendra Varaprasad; Rajasekhar, Liza

doi:10.1136/annrheumdis-2016-eular.5181

Cited by 2 publications

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“…Pentraxin 3 is produced in the inflammatory region by dendritic cells, vascular smooth muscle cells, fibroblasts and macrophages through the trigger of proinflammatory cytokines, especially TNF-α. The levels are raised in TA and have a better specificity and sensitivity in delineating active and inactive disease [6,11,12] . Interleukins, such as IL-6 and IL-8, IL-18, BAFF and anti-endothelial and anti-aorta antibodies are correlated with disease activity in TA [13] .…”

Section: Laboratory Findingsmentioning

confidence: 99%

Management of cardiac manifestations in Takayasu arteritis

Idhrees¹,

Thilagavathi²,

Bashir³

et al. 2020

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Takayasu arteritis (TA) is a chronic vasculitis involving large vessels of unknown aetiology, a disease that is more common among the Asian population and predominant in young women. Cardiac manifestations include hypertension and involvement of the cardiac valves, myocardium and coronary arteries. Surgery on these patients is always a challenge given the tissue quality and the disease activity. They are prone to long-term complications such as restenosis and graft occlusion, hence requiring lifelong surveillance. The prevalence of coronary artery disease (CAD) in TA ranges from 9 to 11%. Coronary artery bypass grafting is preferred to percutaneous coronary intervention, as the latter has a high rate of restenosis and major adverse cardiovascular events. As left subclavian artery is commonly involved, saphenous vein graft is advised as a conduit rather than internal mammary artery. Other surgical procedures described for CAD are surgical angioplasty of the left main coronary artery and transaortic coronary ostial endarterectomy. Aortic regurgitation in TA has an incidence of approximately 20%. These patients tend to have prosthetic valve detachment, paravalvular leak or pseudoaneurysm at the anastomotic site. Further repair of these valves have a high rate of failure. Considering these facts, it is advisable to do an aortic root replacement for TA patients than to consider an aortic valve replacement or David's procedure.

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Section: Laboratory Findingsmentioning

confidence: 99%

Management of cardiac manifestations in Takayasu arteritis

Idhrees¹,

Thilagavathi²,

Bashir³

et al. 2020

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“…Conclusions: It was gratifying to see that randomised trials formed the majority (17/22, 77%) of the sources forming the basis for the recommendations related to skin mucosa and joint involvement in the updated EULAR recommendations for the management of BS. 2 and ITAS-ESR. Serum PTX3 levels (pg/ml) was measured in TA patients and controls, hsCRP (ng/ml)and ESR (mm/hr)were measured in TA patients.…”

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confidence: 99%

SAT0362 Mycophenolate Mofetil versus Methotrexate in The Management of Large Vessel Giant Cell Arteritis

Dospinescu

Karabayas

Kidder

et al. 2016

Annals of the Rheumatic Diseases

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BackgroundThere is an unmet clinical need to identify an effective conventional adjuvant immunosuppressive agent in the treatment of large vessel giant cell arteritis. Traditionally the therapeutic approach has employed prolonged courses of high dose glucocorticosteroids (GC) with poor long-term outcomes. Methotrexate (MTX) is currently recommended as adjuvant GC sparing immunosuppression based on modest evidence1,2. Evidence for the use of Mycophenolate mofetil (MMF) in this setting is lacking.ObjectivesWe investigated the outcome of MMF and MTX usage in an extended cohort of large vessel giant cell arteritis (LVV-GCA) patients from 2 large tertiary centres in the United Kingdom.MethodsWe retrospectively analysed laboratory and treatment outcomes for United Kingdom patients diagnosed with LVV-GCA between January 2008 and January 2015 who attended two geographically distinct specialist Vasculitis Clinics. The two centres use different first line GC sparing agents in LVV GCA, one generally uses MMF the other MTX.Following retrospective record review, cases were selected based on radiologic evidence of large vessel vasculitis, fulfilment of the Chapel Hill Consensus Conference 2012 GCA definition and a first line prescription of GC with adjuvant MMF or MTX. Baseline and follow up characteristics were collated. Unpaired t-test was used to compare differences between the groups.ResultsTwenty patients (7 male) were identified in total: 11 patients (3 male) treated with MMF and 9 patients (4 male) treated with MTX. Mean age (SD) at diagnosis was 66.15 (7.1) years with the MMF group being older (68.9 (5.9) versus 62.7 (7.2) years). Positron emission tomography–computed tomography (PET CT) confirmed evidence of active large vessel vasculitis in all patients.At diagnosis, there was no significant difference between the mean CRP value between the two groups (56.1 (46.9) versus 47.7 (34.3) mg/l, p=0.67). Following 6 weeks of treatment, there was a dramatic reduction in the mean CRP level in both groups (8.1 (8.7) versus 3.1 (2.2), p=0.14), a response which was maintained at one year (7.6 (5.8) versus 4.5 (3.1), p=0.16). Although at diagnosis Prednisolone dose was higher in the MMF group (54.5 (9.3) versus 41.1 (17.6) mg, p=0.042), no significant difference was found between the groups at 6 weeks (24.1 (5.4) versus 29.1 (12.8) mg, p=0.26) and throughout the year (8.4 (2.8) versus 5.8 (3.7) mg, p=0.1 at one year)ConclusionsTo our knowledge, we describe the first case-series of MMF use in LV-GCA.Within the limitations of this study, MMF appears to be comparable to MTX as adjunctive therapy in patients with LV-GCA, allowing a rapid taper of GC. A randomized controlled trial is required to further evaluate the role of MMF in this challenging disease subset.ReferencesMukhtyar C et al. EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2009 Mar; 68(3):318–23.Mahr AD et al. Adjunctive Methotrexate for treatment of giant cell arteritis: an individual patient data meta-analysis. Arthritis Rheum 2007; 5...

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SAT0364 Pentraxin 3 as Biomarker in Assessment of Disease Activity in Takayasu Arteritis

Cited by 2 publications

References 0 publications

Management of cardiac manifestations in Takayasu arteritis

Management of cardiac manifestations in Takayasu arteritis

SAT0362 Mycophenolate Mofetil versus Methotrexate in The Management of Large Vessel Giant Cell Arteritis

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