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Update on Takayasu's arteritis.

Fatma Alibaz-Oner1, Haner Direskeneli2

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Takayasu arteritis (TAK), a large-vessel vasculitis, is seeing advances in diagnosis and treatment. New imaging and scoring systems improve disease assessment, while novel therapies offer hope for resistant cases.

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Area of Science:

  • Rheumatology
  • Immunology
  • Vascular Medicine

Background:

  • Takayasu arteritis (TAK) is a rare, chronic large-vessel vasculitis affecting the aorta and its branches.
  • It predominantly impacts the aorta, its major branches, and pulmonary arteries.

Purpose of the Study:

  • To review recent advancements in Takayasu arteritis (TAK).
  • Focus on genetics, clinical course, prognosis, disease assessment, and novel treatment options.

Main Methods:

  • Review of current literature on Takayasu arteritis.
  • Discussion of new diagnostic and assessment tools, including imaging and scoring systems.
  • Exploration of emerging therapeutic strategies.

Main Results:

  • Magnetic Resonance Angiography (MRA) and 18-FDG-PET are increasingly used for diagnosis and activity assessment, potentially replacing conventional angiography.
  • New scoring systems like the Indian Takayasu Arteritis Score (ITAS2010) and CDUS aim for better disease quantification.
  • Prognosis appears to be improving with lower mortality, though vascular intervention rates vary.
  • Leflunomide, TNF-α antagonists, and tocilizumab are identified as new treatment options for refractory cases.

Conclusions:

  • Significant progress has been made in diagnosing and managing Takayasu arteritis.
  • Advanced imaging and refined assessment tools are enhancing disease monitoring.
  • Emerging therapies offer improved outcomes for patients with treatment-resistant disease.