Session Type: Poster Session (Sunday)
Session Time: 9:00AM-11:00AM
Background/Purpose: Takayasu arteritis (TAK) occurs at a young age and has a long-term clinical course. Progression of arterial stenosis or dilatation leads to organ dysfunction. To provide information for improvement of the treatment strategies, we surveyed the treatments, complications, damages, and activities of daily living in the long-term clinical course of TAK, using the data of 2013 patients from the national registry of Japan.
Methods: Data of 211 newly registered and 2584 continuously registered patients were obtained from the case report forms for TAK in the year 2013 from the national registry. We excluded cases with inconsistent data and age of onset >60 years, leaving 76 newly registered and 1937 continuously registered patients. The patients were analyzed by stratification into four groups: 1) new and 2) disease duration < 5 years, 3) 5–20 years, and 4) >20 years (n=76, 273, 766, and 898; mean current age=34, 35, 46, and 62 years; female ratio=84%, 85%, 86%, and 95%, respectively).
Results: The mean prednisolone dose was lower in patients with longer disease duration: (new, < 5 years, 5-20 years, >20 years = 34, 14, 8, and 6 mg/day, respectively) (Table 1). Immunosuppressants (IS) were used in 44% of patients after initiation of glucocorticoid (GC). The frequencies of fever (67%, 30%, 11%, and 4%, respectively) and CRP levels (6.7, 0.8, 0.5, and 0.6 mg/dL, respectively) were also lower in patients with longer disease duration. Conversely, the frequencies of aortic regurgitation (24%, 22%, 32%, and 47%, respectively), aortic aneurysm (12%, 9%, 12%, and 15%, respectively), ischemic heart disease (3%, 4%, 6%, and 19%, respectively), and blindness (0%, 0%, 0.4%, and 1.8%, respectively) tended to be higher in patients with longer disease duration (Fig. 1). The percentage of patients with severe disease (Class IV + V) (20%, 10%, 13%, and 22%, respectively) was high at onset, decreased after initiation of therapy, and showed an increasing tendency depending on disease duration. The percentage of workers was < 50% irrespective of disease duration (Fig. 2).
Conclusion: In this cohort, treatments with GC (initially medium dose) and IS (approximately 40%) were suggested to improve the disease activity of TAK. However, the frequency of complications and damages showed an increasing tendency depending on disease duration, leading to a limited social role.
To cite this abstract in AMA style:Yoshifuji H, Uchida H, Nakaoka Y, Sugihara T, Isobe M, Harigai M. Long-term Clinical Course and Outcomes of 2013 Patients with Takayasu Arteritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/long-term-clinical-course-and-outcomes-of-2013-patients-with-takayasu-arteritis/. Accessed December 5, 2020.
« Back to 2019 ACR/ARP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/long-term-clinical-course-and-outcomes-of-2013-patients-with-takayasu-arteritis/