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Treatment modalities and ANCA in Takayasu's arteritis
M Schwarz-Eywill1, A Breitbart, E Csernok
1Department of Rheumatology, Medical University of Lübeck, Germany.
Advances in Experimental Medicine and Biology
|January 1, 1993
Insights
Takayasu
Area of Science:
- Rheumatology
- Immunology
- Internal Medicine
Background:
- Takayasu's Arteritis is a rare vasculitis requiring long-term immunosuppression.
- Steroids are common but have significant long-term side effects.
- Alternative immunosuppressive therapies are needed.
Purpose of the Study:
- To evaluate low-dose methotrexate as an alternative immunosuppressive therapy for Takayasu's Arteritis.
- To assess the efficacy of methotrexate in controlling disease activity and reducing steroid dependence.
- To investigate the presence of autoantibodies (c-/p-ANCA, neutrophil granular enzymes) in patients with Takayasu's Arteritis.
Main Methods:
- Retrospective case series of 3 patients with Takayasu's Arteritis treated with low-dose methotrexate.
- Monitoring of disease activity and steroid dosage.
- Screening of 16 patients for c-/p-ANCA and neutrophil granular enzymes.
Main Results:
- Low-dose methotrexate effectively controlled disease activity in all 3 treated patients.
- Steroid dosage was reduced or discontinued in all patients receiving methotrexate.
- No patient screened was positive for c-/p-ANCA or neutrophil granular enzymes.
Conclusions:
- Low-dose methotrexate is a viable and effective alternative immunosuppressive therapy for Takayasu's Arteritis.
- Methotrexate can facilitate steroid reduction or cessation, mitigating long-term steroid-related complications.
- Autoantibodies like c-/p-ANCA and neutrophil granular enzymes do not appear to be associated with Takayasu's Arteritis in this cohort.
Abstract:
As other vasculitic-syndromes Takayasu's-Arteritis needs a long-term immunosuppressive therapy in order to control disease-activity. As steroids create many problems in the long run other immunosuppressives should be considered. We report 3 cases treated with low-dose methotrexate. In all patients the arteritis was controlled, steroids reduced or stopped. In the effort to find autoantibodies 16 patients were screened for c-/p-ANCA and neutrophil granular enzymes. In no patient a positive result could be obtained.