Predictors of relapse in Takayasu arteritis

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Takayasu arteritis (TAK) is a significant large-vessel vasculitis characterized by a high rate of disease relapse.
• Limited longitudinal studies exist on identifying risk factors associated with TAK relapse.
• Understanding these factors is crucial for improving patient management and outcomes.

Purpose of the Study:

• To identify key factors associated with relapse in Takayasu arteritis patients.
• To develop and validate a predictive model for estimating the risk of relapse in TAK.
• To stratify patients into distinct risk groups for targeted clinical intervention.

Main Methods:

• A prospective cohort study involving 549 TAK patients was conducted from June 2014 to December 2021.
• Univariate and multivariate Cox regression analyses were employed to determine relapse risk factors.
• A prediction model was developed and validated using C-index and calibration plots, stratifying patients into low, medium, and high-risk groups.

Main Results:

• Over a median follow-up of 44 months, 50.3% of patients experienced relapse.
• Independent risk factors for relapse included prior relapse history, disease duration <24 months, cerebrovascular events, aneurysm, specific aortic involvement, elevated hs-CRP, elevated WBC count, and ≥6 involved arteries.
• The developed prediction model demonstrated good discrimination (C-index 0.70) and calibration.

Conclusions:

• Disease relapse is a frequent occurrence in Takayasu arteritis.
• The developed prediction model effectively identifies patients at high risk for relapse.
• This tool can aid clinicians in making informed decisions for personalized patient management and treatment strategies.