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FRI0260 The Assessment of Disease Activity in Takayasu Arteritis; Six Years Experience from a Single Center
  1. S. Gulsaran1,
  2. P. Cetin2,
  3. D. Solmaz2,
  4. S. Akar2,
  5. H. Yarkan2,
  6. A. Gulcu3,
  7. Y. Goktay3,
  8. M. Birlik2,
  9. N. Akkoc2,
  10. F. Onen2
  1. 1Internal Medicine
  2. 2Rheumatology
  3. 3Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey

Abstract

Background Takayasu Arteritis (TA) is a chronic vasculitis of the aorta and its major branches affecting commonly young females. The current clinical and laboratory parameters of TA are insufficient for proper assessment of disease activity.

Objectives The aim of this study is to analyze the activity parameters that affect the physicians' global opinion (PGO) in TA.

Methods The demographic and clinical data of patients with TA who were followed in the Rheumatology clinic at Dokuz Eylul University were retrospectively evaluated. Disease activity was assessed using various tools, including Kerr's criteria, disease extent index-Takayasu (DEI.Tak), the Indian Takayasu Activity Score (ITAS2010), PGO, radiological activity parameters, and acute-phase reactants at every 3-6 months.According to the TA follow-up protocol of the Rheumatology and Radiology Board of our hospital, the patients were followed using 3-6 monthly B-mode/Doppler US examinations and 6-12 monthly magnetic resonance imaging (MRI) examinations with MRA.The agreement between disease activity parameters were assessed by kappa coefficient and Spearman rank correlation.

Results In total, 52 patients (48 females; mean age: 46.8±13.2 years) who fulfilled the American College of Rheumatology (ACR) criteria for TA were enrolled in this study. Their mean disease duration was 9.7±7.6 years and mean follow-up duration was 6.4±2.9 years. 33 (63.5%) patients had type 5 TA and 13 (25%) had type 1 TA. 40 (76.9%) patients were categorized as having active disease in their first visits according to PGO. In the last visit, 31 (59.6%) patients had inactive disease, 19 (36.5%) had persistent disease and 2 (%3.9) had active disease. All the patients used the long-term glucocorticoid therapy and DMARD/immunosuppressive drugs. Six (%11.5) of them were on the treatment with biologics. Five (9.6%) patients underwent vascular surgery and 35 (67.3%) were performed endovascular repair for arterial stenosis. In total, 360 visits of 52 patients were evaluated. PGO was that the disease was inactive in the 181 visits, persistan in the 99 visits and active in the 80 visits. To obtain more clear results, visits with persistan disease were excluded and final evaluation included the 261 visits of 52 TA patients. Correlations of the clinical, laboratory and radiological activity parameters with each other and PGO were shown in Table 1.

Table 1.

Agreement rates and correlations of the disease activity parameters with each other and PGO in Takayasu arteritis

Conclusions The results of this study suggests that imaging had a significant impact on physician's decision regarding disease activity in TA. Although disease activity scores including NIH, DEI-Tak and ITAS2010 were well correlated with each other, there was a poor agreement between CRP and all the other activity parameters.

Disclosure of Interest None declared

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