Large-vessel vasculitis
Imaging is the major determinant in the assessment of disease activity in Takayasu's arteritis
G. Kenar1, S. Karaman2, P. Çetin3, H. Yarkan4, S. Akar5, G. Can6, Ö. Alataş7, A. Gülcü8, F. Önen9
- Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey. gokcekenar@gmail.com
- Department of Internal Medicine, Dokuz Eylul University School of Medicine, Izmir, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Katip Celebi University School of Medicine, Izmir, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
- Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
- Department of Radiology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
- Department of Internal Medicine, Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey.
CER12642
2020 Vol.38, N°2 ,Suppl.124
PI 0055, PF 0060
Large-vessel vasculitis
Free to view
(click on article PDF icon to read the article)
PMID: 31820717 [PubMed]
Received: 28/07/2019
Accepted : 14/10/2019
In Press: 06/12/2019
Published: 21/05/2020
Abstract
OBJECTIVES:
There are no valid follow-up parameters in the assessment of disease activity in Takayasu’s arteritis (TAK). We investigated the impact of vascular imaging in the assessment of disease activity.
METHODS:
Patients with TAK who fulfilled the ACR criteria were included. Physician global assessment (PGA), the criteria defined by Kerr et al. and the Indian Takayasu Clinical Activity Score (ITAS2010) were evaluated. Patients were followed up since 3-6 months B-mode/Doppler ultrasonography (US) and 6-12 monthly magnetic resonance imaging/angiography (MRI/MRA). Active disease according to vascular imaging (Rad-Active) was defined based on the presence of any of the 3 parameters: (1) new vessel involvement by any imaging technique; (2) an increase in vessel wall thickness on US compared to previous one; (3) the presence of mural contrast enhancement/oedema on MRI/ MRA. The agreement of Rad-Active with other disease activity indexes was studied. Furthermore, ITAS-A-Rad index was developed by combining the vascular imaging with ITAS-A.
RESULTS:
A total of 410 visits in 52 patients were evaluated. The agreement was found to be 76% (κ: 0.52) between Rad-Active and PGA; 83% (κ: 0.57) between Rad-Active and Kerr's criteria. Both the agreements of ITAS2010 and acute phase reactants with PGA (69%, κ:0.38 and 60%, κ:0.22, respectively) and also Kerr’s criteria (78%, κ:0.49 and 42%, κ:0.05, respectively) were lower compared to those of Rad-Active. Mean ITAS-A-Rad scores were higher in visits with active disease according to PGA and Kerr’s criteria.
CONCLUSIONS:
The results of this study suggest that the vascular imaging should be included in the assessment of disease activity in TAK.
