ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 901

Clinical Features of  Takayasu’s Arteritis from an Inception Cohort: Early Disease Is Characterized By ‘systemic Inflammation’

Fatma Alibaz-Oner1, Ali Ugur Unal2, Ahmet Mesut Onat3, Bunyamin Kisacik4, Orhan Zengin5, Omer Karadag6, Abdulsamet Erden6, Handan Yarkan7, Servet Akar8, Fatih Yildiz9, Eren Erken10, Huseyin Özer11, Ahmet Omma12, Zeynep Ozbalkan13, Yasar Karaaslan14, Cemal Bes15, Sibel Yilmaz Oner15, Nilufer Alpay Kanitez15, Ozun Bayndır16, Sule Yavuz17, Nursen Duzgun18, Ayse Nur Tufan19, Ediz Dalkilic19, Hajime Yoshifuji20, Abdurrahman Tufan17, Lutfi Akyol21, Mehmet Akif Ozturk22, Mehmet Sayarlioglu23, Kenan Aksu16, Gokhan Keser24, Sedat Kiraz25, Omer Nuri Pamuk26, Fatos Onen27 and Haner Direskeneli28, 1Department of Rheumatology, Marmara University Faculty of Medicine, Istanbul, Turkey, 2Marmara University, School of Medicine, Rheumatology, Istanbul, Turkey, 3Department Of Internal Medicine, Division of Rheumatology, Gaziantep University, Gaziantep University,Division of Rheumatology, Gaziantep, Turkey, 4Rheumatology Department, Gaziantep University School of Medicine, Gaziantep, Turkey, 5Rheumatology, Gaziantep University School of Medicine, Gaziantep, Turkey, 6Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey, 7Rheumatology, Dokuz Eylul University Faculty of Medicine, İzmir, Turkey, 8Department of Rheumatology, İzmir Katip Çelebi University, School of Medicine, İzmir, Turkey, İzmir, Turkey, 9Rheumatology, Van EAH, Adana, Turkey, 10Rheumatology, Cukurova University Faculty of Medicine, Adana, Turkey, 11Rheumatology, Cukurova Univesity, School of Medicine, Adana, Turkey, 12Department of Internal Medicine, Rheumatology Division, Ankara Numune Hospital, Ankara, Turkey, 13Rheumatology Departent, MD,Assoc. Prof., Ankara, Turkey, 14Rheumatology, Turkish Takayasu's Arteritis Study Group, Istanbul, Turkey, 15Rheumatology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey, 16İnternal Medicine Division of Rheumatology, Ege University Medical Faculty, Izmir, Turkey, 17PsART study group, Ankara, Turkey, 18Internal Medicines, Rheumatology Department, Ankara University School of Medicine, Ankara, Turkey, 19Rheumatology, Uludag University Medcal Faculty, Bursa, Turkey, 20Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan, 21Department of Internal Medicine Division of Rheumatology, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey, 22Internal Medicine-Rheumatology, Gazi University Medical School, Ankara, Turkey, 23Rheumatology, Ondokuz Mayis University School of Medicine, Samsun, Turkey, 24Rheumatology, Ege University Medical Faculty, Izmir, Turkey, 25Hacettepe University Vasculitis Center (HUVAC), Ankara, Turkey, 26Department of Rheumatology, Trakya University School of Medicine, Edirne, Turkey, 27Rheumatology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey, 28Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords:

Session Information

Date: Sunday, November 13, 2016

Title: Vasculitis - Poster I: Large Vessel Vasculitis and Polymyalgia Rheumatica

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:  There is only retrospective and very limited data for the long term prognosis of Takayasu’s Arteritis (TAK), a rare large-vessel vasculitis. In this study, we aimed to present the preliminary results of a Takayasu Inception Cohort settled for long term, prospective follow-up of only newly-diagnosed patients with TAK.

Methods: Patients fullfilling the ACR 1990 criteria for TAK and diagnosed in the last 12 months were included to the study. Patients’ data were recorded in an electronic database of an international “Takayasu’s Arteritis Registry” requiring baseline and at least annual visits. Data is compared with an historical Turkish cohort previously published  by Turkish Takayasu Arteritis Study Group(Bıçakçıgil, et al, 2009).

Results: The study included 128 patients (age: 38.9±13.1 years,F/M: 112/16) with TAK from 15 tertiary Rheumatology centers in Turkey and one center from Japan. The mean symptom duration was 5.2 years at diagnosis. According to the angiographic classification, 59.2% of the study group had type I and only 17.2% had type V disease. When we compared our results to our retrospective cohort, constitutional symptoms (72.2% vs 66%) and limb claudication (62.3% vs 48%) were observed to be more frequent, whereas pulselessness (35.6% vs 88%) was less in the inception cohort.(Table 1) Carotidynia was present only in the inception cohort. Similarly, mucocutaneous symptoms also seem to be a feature of newly-diagnosed disease (26.4% vs 8.8%).Regarding comorbidities at diagnosis, the rate of dyslipidemia was 22%, diabetes mellitus 6%, smoking 28.5% and obesity ( BMI>30) 15.8% among TAK patients. All patients were givenoral corticosteroid (CS) therapy (0.5-1 mg/kg) at diagnosis, 10 patients (7.8%) also having CS pulses. In addition to CSs, 55 patients (43 %) were given methotrexate, 14 patients (11%) azathioprine and 5 (4%) cyclophosphomide at disease-onset.

Conclusion: Our results suggest that, in an inception cohort, signs and symptoms of ‘systemic inflammation’ is more prominent in newly-diagnosed TAK patients, whereas vascular extent and damage accumulates during the disease course. The long term follow-up of our inception cohort will better show the actual course and predictors of prognosis in TAK. Table 1: Clinical characteristics of Inception and Retrospective Cohorts from Turkey.

Inception Cohort

(n=128)

Retrospective Cohort

(Bıçakçıgil, et al)

(n=248)

Constitutional symptoms

91/126 (72.2%)

163/248/ (66%)

Limb claudication

66/106 (62.3% )

119/248 (48%)

Carotidynia

26/104 (25%)

–

Pulseless

37/104 (35.6%)

218/248 (88%)

Musculoskeletal manifestations

66/124 (53.2%)

104/248 (42%)

Mucocutaneous manifestations

32/121 (26.4)

 22/248 (8.8%)

Respiratory manifestations

40/122 (32.8%)

22/184 (12%)

Neurologic manifestations

58/124 (46.8%)

156/248 (63%)

Cardiac involvement

23/106 (21.7 %)

141/248 (57%)

Ophthalmologic involvement

29/125 (23.2%)

57/248 (36%)

Disclosure: F. Alibaz-Oner, None; A. U. Unal, None; A. M. Onat, BMS, 8,MSD, 8,Pfizer Inc, 8,UCB, 8,Roche Pharmaceuticals, 8; B. Kisacik, None; O. Zengin, None; O. Karadag, Pfizer Inc, 2,Abbvie, 2,Abbvie, 5,BMS, 5,MSD, 5,Pfizer Inc, 5,Roche Pharmaceuticals, 5,UCB, 5,Sanofi-Aventis Pharmaceutical, 5; A. Erden, None; H. Yarkan, None; S. Akar, None; F. Yildiz, None; E. Erken, None; H. Özer, None; A. Omma, None; Z. Ozbalkan, None; Y. Karaaslan, None; C. Bes, None; S. Yilmaz Oner, None; N. Alpay Kanitez, None; O. Bayndır, None; S. Yavuz, None; N. Duzgun, None; A. N. Tufan, None; E. Dalkilic, Abbvie, 8,MSD, 8,Roche Pharmaceuticals, 8,UCB, 8,Pfizer Inc, 8; H. Yoshifuji, None; A. Tufan, None; L. Akyol, None; M. A. Ozturk, None; M. Sayarlioglu, None; K. Aksu, None; G. Keser, None; S. Kiraz, None; O. N. Pamuk, None; F. Onen, None; H. Direskeneli, None.

To cite this abstract in AMA style:

Alibaz-Oner F, Unal AU, Onat AM, Kisacik B, Zengin O, Karadag O, Erden A, Yarkan H, Akar S, Yildiz F, Erken E, Özer H, Omma A, Ozbalkan Z, Karaaslan Y, Bes C, Yilmaz Oner S, Alpay Kanitez N, Bayndır O, Yavuz S, Duzgun N, Tufan AN, Dalkilic E, Yoshifuji H, Tufan A, Akyol L, Ozturk MA, Sayarlioglu M, Aksu K, Keser G, Kiraz S, Pamuk ON, Onen F, Direskeneli H. Clinical Features of  Takayasu’s Arteritis from an Inception Cohort: Early Disease Is Characterized By ‘systemic Inflammation’ [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/clinical-features-of-takayasus-arteritis-from-an-inception-cohort-early-disease-is-characterized-by-systemic-inflammation/. Accessed .

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