Takayasu arteritis: assessment of response to medical therapy based on clinical activity criteria and imaging techniques

Abstract

In this retrospective longitudinal cohort study we included 52 patients with Takayasu arteritis (TA) who were on regular follow-up at the Vasculitis Unit of Universidade Federal de São Paulo between 2003 and 2009. The mean age at study was 38 years and the mean age at diagnosis was 29 years. Patients were followed for a mean 74.3 months. A relapse-remitting course was observed in 41 patients (78.8%) whereas 9 (17.3%) had a monophasic course and only 2 (3.8%) patients were chronic-active. Disease remission was achieved in 50 patients (96.2%). Angiographic type V was observed in 42.3% of TA patients at diagnosis and in 61.5% during follow-up. The most affected arteries were the abdominal aorta (63.5%) and left subclavian (60.6%). Prednisone was used by 94% of TA patients and immunosuppressive agents were prescribed for 51 (98%) patients. Methotrexate was used by 82.7%, followed by cyclophosphamide (26.9%), azathioprine (25.0%), anti-TNFα agents (5.8%) and leflunomide (5.8%). Although, forty patients (76.9%) used prednisone and methotrexate as initial treatment, 75% of them developed new vascular lesions along follow-up. Eighteen TA patients (34.6%) needed to change immunosuppressive therapy due to failure or toxicity, among them 83.3% presented new lesions. Surgical treatment was performed in 34.6% of patients and restenosis was observed in 13.5% in a median time of 11 months after surgery. In conclusion besides prednisone and methotrexate is largely used in TA, the majority of patients still develop new arterial lesions along time.

The clinical characteristics of Chinese Takayasu’s arteritis patients: a retrospective study of 411 patients over 24 years

“…We found another six cohort studies from different geographic areas [12, 20–24] which also described the details of involved vessels. The occurrence rate of carotid artery and subclavian artery involvement was similarly high, but the occurrence rates of aortic involvement and aortic aneurysm were different (Table 3).…”

Migratory large vessel vasculitis preceding acute myeloid leukemia: a case report

“…Marked systemic inflammation may be a feature of TA, however this disorder classically affects individuals younger than 50 years of age [3, 4]. GCA, more frequently seen in older individuals, typically involves smaller vessels such as the temporal arteries, but can also affect the aorta and its major branches.…”

Takayasu Arteritis: Diagnosis, Treatment and Prognosis

“…The common causes of death may be acute myocardial infarction, congestive heart failure, cerebrovascular accident, renal failure, postoperative complications and so on [71][72][73]. The reported survival rate in patients with TA was inconsistent in several studies, ranging from 67 to 100% (at both 5 and 10 years follow up).…”