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Prognosis of large vessel involvement in large vessel vasculitis

Mathieu Vautier1, Axelle Dupont2, Hubert de Boysson3

  • 1Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes et Systémiques Rares, Centre de Référence des Maladies Auto- Inflammatoires, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, And Inflammation- Immunopathology-Biotherapy Department (DHU I2B), F-75005, Paris, France; INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, France.

Journal of Autoimmunity
|February 10, 2020
PubMed

Insights

Large vessel involvement (LVI) in large vessel vasculitis (LVV) impacts prognosis. Takayasu arteritis (TAK) and Giant Cell Arteritis with LVI (GCA-LVI) show distinct long-term outcomes regarding aneurysms, relapses, and revascularization needs.

Area of Science:

  • Rheumatology
  • Vascular Medicine
  • Internal Medicine

Background:

  • Large vessel vasculitis (LVV) encompasses conditions like Takayasu arteritis (TAK) and Giant Cell Arteritis (GCA).
  • Large vessel involvement (LVI) is a significant characteristic influencing patient prognosis in LVV.
  • Understanding prognosis factors and outcomes in LVI is crucial for effective patient management.

Purpose of the Study:

  • To identify prognosis factors for vascular complications in patients with LVV and LVI.
  • To compare the long-term outcomes of LVI in TAK versus GCA patients.

Main Methods:

  • A retrospective multicenter study analyzed data from 417 patients with LVI.
  • Included 299 patients with TAK and 118 patients with GCA-LVI.
  • Logistic regression assessed prognosis factors; outcomes (ischemic complications, aneurysms, relapses, revascularization) were evaluated.

Main Results:

  • Stroke/transient ischemic attack was independently associated with vascular complications in LVV.
  • GCA-LVI patients had significantly lower 10-year aneurysm-free survival compared to TAK patients.
  • GCA-LVI patients experienced significantly lower 5-year relapse-free survival than TAK patients.
  • TAK patients had significantly lower 10-year revascularization-free survival compared to GCA-LVI patients.

Conclusions:

  • This study provides key prognosis factors for vascular complications in LVV patients with LVI.
  • TAK and GCA-LVI demonstrate differing long-term prognoses concerning aneurysm development, relapse rates, and revascularization requirements.
Abstract

Keywords:
Giant cell arteritisOutcomePrognosisTakayasu arteritisVasculitis

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