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FRI0459 Characteristics and Long-Term Outcome of 122 Patients with Takayasu Arteritis
  1. C. Comarmond1,
  2. T. Mirault2,
  3. P. Cluzel3,
  4. F. Koskas4,
  5. L. Chiche4,
  6. J. Gaudric4,
  7. E. Messas2,
  8. P. Cacoub1,
  9. D. Saadoun1
  1. 1Internal Medicine, Groupe Hospitalier Pitié-Salpêtrière
  2. 2Vascular Medicine, HEGP
  3. 3Vascular and Interventional Radiology, Hôpital Pitié-Salpêtrière
  4. 4Vascular Surgery, Groupe Hospitalier Pitié-Salpêtrière, Paris, France

Abstract

Background Takayasu arteritis (TA) is a chronic inflammatory disease that primarily affects large vessels, such as the aorta and its main branches.

Objectives To report clinical features, morphologic findings, treatment and long-term outcome of a large cohort of patients with TA.

Methods We performed a retrospective multicenter study of characteristics and outcome of 122 patients with TA fulfilling the American College of Rheumatology criteria.

Results The median age [Q1; Q3] at onset of symptoms was 35.4 [24.4; 46.3] years and with a predominance of females (n=103, 84.4%). The median delay of diagnosis was 10 [0; 46.25] months. The most common clinical findings were vascular bruits (n=66, 54.1%), upper extremity blood pressure discrepancy >10 mm Hg (n=57, 46.7%), and unequal or absent pulses (n=55, 45.1%). Major complications at diagnosis were hypertension (n=41, 33.6%), aortic regurgitation (n=24, 19.7%), aneuvrysm (n=30, 24.6%) and retinopathy (n=3, 2.1%). Fifty five (45%) patients had extensive disease at diagnosis according to Numano type V. Twenty four (19.7%) patients had another inflammatory or auto-immune disease associated to TA. Stenotic lesions were 3.1-fold more common than were aneuvrysms (77.9% versus 24.6%, respectively). Revascularization procedure was required for 53 (43.4%) patients. The median delay between diagnosis and first surgery or endovascular intervention was 5 [0; 17.5] months. Medical therapy (i.e. corticosteroids) was prescribed in 107 (87.7%) patients. The median delay in initiation of corticosteroids was 1 [0; 5] months. Eighty one (66.4%) patients required additional immunosuppressive agent. The median delay in initiation of the first immunosuppressor was 11 [2; 29.5] months. Fifty four (44.3%) patients relapsed after a median follow-up of 64.5 [24.9; 124.5] months. The median relapse-free survival was 16 [7; 62.25] months.

Conclusions Most patients with TA require prolonged and intensive medical therapy. However, relapse and revascularization are frequents, occurring in nearly half of patients.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.5926

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