Photo Credit: ALIOUI Mohammed Elamine

A retrospective study on patients with Takayasu arteritis (TA) reveals a notable prevalence of aneurysmal disease, associated with increased risk of rupture and higher relapse rates.

The following is a summary of “Aneurysmal Disease in Patients With Takayasu Arteritis,” published in the December 2023 issue of Rheumatology by Lefebvre et al.

Takayasu arteritis (TA) results in stenotic conditions, with aneurysmal lesions less common. Researchers conducted a retrospective study to investigate the primary features of aneurysmal disease within a Canadian group of individuals diagnosed with TA.

They conducted a monocentric study encompassing patients with TA under the Mount Sinai Hospital Vasculitis Clinic in Toronto. The diagnosis of TA relied on clinical findings and meeting the 1990 American College of Rheumatology classification criteria.

They included 74 patients with aneurysmal disease identified in 23 individuals (31%) at any given time. The median duration of the disease was 9.0 years (IQR 7.0-19.0). They observed a higher prevalence of prior hypertension (P = 0.02), fever (P=0.04), and seizure disorders (P=0.03). The limb claudication occurred less frequently (P=0.01). Follow-up revealed persistent and new aneurysms in 22/23 patients. The aneurysms were located at the thoracic aorta (13/22), followed by the abdominal aorta (8/22), subclavian (7/22), and carotid (6/22) arteries. Aortic valve regurgitation was more frequent in patients with aneurysmal disease (9/23 vs. 3/48; P=0.001). Glucocorticoid treatment had been administered to 21 patients for a median of 6.1 years (IQR 3.7-8.1). Methotrexate, azathioprine, and leflunomide were consistently used. The infliximab was more frequently used in patients with aneurysmal disease (7/23, P=0.04), whereas tocilizumab was received by only 4 patients (P=0.01). Those with aneurysms experienced more frequent relapses (2.0 [IQR 0.0-4.0] versus 1.0 [IQR 0.0-2.0], P=0.04).

Investigators concluded that the prevalent occurrence of aneurysmal disease in TA patients, with its inherent risk of rupture and association with a higher rate of relapse, underscores the imperative for systematic reporting of this finding in TA studies.

Souce: jrheum.org/content/early/2024/01/09/jrheum.2023-0629