Treatment of resistant Takayasu's arteritis

About 20% of patients will have a monophasic, often self-limiting illness that does not require immunosuppressive therapy. Half of all patients that require corticosteroid therapy may achieve remission and discontinue medication without relapse. The other half of this group has glucocorticoid-resistant or relapsing disease, for which cytotoxic agents may induce remission or allow for disease control with lower doses of glucocorticoids. Although it is possible, it is desirable to distinguish those features of disease for which treatment is primarily best provided by immunosuppressive agents from those abnormalities that are due to critical vascular anatomic changes for which surgery or angioplasty are more appropriate.