Clinical interventions for Takayasu arteritis: A systematic review.

Area of Science:

• Rheumatology
• Internal Medicine
• Vascular Medicine

Background:

• Takayasu arteritis (TA) is a rare, serious large-vessel vasculitis with challenging treatment due to disease relapses and medication side effects.
• Current treatment options like corticosteroids and immunosuppressors often fail, necessitating better evidence-based strategies.
• Limited high-quality research exists on TA treatments, hindering clinical practice recommendations.

Purpose of the Study:

• To systematically review and assess the effectiveness and safety of clinical interventions for Takayasu arteritis.
• To synthesize available evidence to guide clinical practice for managing TA.

Main Methods:

• A systematic review following Cochrane Handbook guidelines was performed.
• Included all comparative studies evaluating any clinical intervention for Takayasu arteritis.
• Searched for randomized clinical trials, non-randomized clinical trials, and historical cohorts.

Main Results:

• Five comparative studies (342 patients) assessed corticosteroids, immunosuppressors, and biologics for TA.
• Study quality was generally low, with significant data scarcity and clinical heterogeneity.
• Meta-analysis was not feasible due to the limitations of the retrieved studies.

Conclusions:

• Few comparative studies of low quality were found, preventing definitive recommendations on TA treatment effectiveness and safety.
• Current treatment decisions for Takayasu arteritis must be individualized based on disease severity and available options.
• Further robust comparative studies with larger sample sizes are crucial for advancing TA treatment guidelines.