Background/Purpose: Damage is one of the consequences of disease and is often considered irreversible. This study aimed to evaluate new arterial damage in Takayasu’s arteritis (TAK).

Methods: Patients with TAK were included in this analysis if they were enrolled in a multicenter, prospective, observational cohort from North America, or seen at a single-center in Turkey, and had available data on vascular imaging. Baseline imaging and imaging at last visit were compared to identify new lesions (stenosis, occlusions, aneurysms) in previously unaffected territories. Variables associated with new arterial damage were evaluated.

Results: The study included 305 patients with TAK: 92% female; mean±SD age 40.9 (13.5) years; median (25th, 75th percentile) disease duration from diagnosis 1.2 (0, 4.9) years; median (25th, 75th percentile) time from symptom onset to diagnosis 54.1 (16.6, 178.2) weeks; median duration of follow-up 5.8 (2.0, 9.4) years. 128 patients (42%) were enrolled ≤ 180 days from time of diagnosis (the “recently diagnosed” group).The lesions on imaging at first visit in all 305 patients are outlined in Table 1. Aneurysmal disease was more frequently observed in the ascending aorta and aortic arch, while stenotic disease was more frequent in the abdominal aorta.204 patients (67%) had at least 1 follow-up imaging study. Median (25th, 75th percentile) time from first available imaging study to last available imaging study was 4.1 (1.6, 8.4) years. 72 patients (35%) had at least 1 new arterial lesion in a previously unaffected territory. Among 95 patients recently diagnosed, 31 patients (32%) had new arterial lesions. The distribution of new vascular lesions is outlined in Table 2. The majority of new lesions were stenoses and occurred in the left carotid artery, abdominal aorta, and superior mesenteric artery. Of the 72 patients with new lesions, 36 patients (50%) had ≥ 2 new lesions (range 2-9).When characteristics were compared between patients with and without new arterial lesions (Table 3), no differences were found in age, sex, time between imaging studies, recent diagnosis, or treatment.

Conclusion: Nearly one-third of patients with TAK develop new, often multiple, arterial lesions during follow-up, indicating significant burden of disease despite treatment. The majority of the new lesions are stenotic or occlusive. Given the frequency of new lesions, serial imaging remains important in the monitoring of TAK. To better capture the longitudinal arterial damage that occurs in this disease, indices of damage in TAK should include data derived from vascular imaging.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/new-arterial-damage-in-takayasus-arteritis/