title: Takayasu arteritis in France: a single-center retrospective study of 82 cases comparing white, North African, and black patients.
abstract: We conducted a single-center retrospective study to compare the characteristics of Takayasu arteritis (TA) among white, North African, and black patients in a French tertiary care center (Hospital Pitié-Salpêtrière, Paris). Eighty-two patients were studied (82.9% female) during a median follow-up of 5.1 years (range, 1 mo to 30 yr). Among these 82 patients, 39 (47.6%) were white, 20 (24.4%) were North African, and 20 (24.4%) were black patients. Median age at diagnosis was 39.3 years (range, 14-70 yr) in white patients vs. 28.4 years (range, 12-54 yr) in North African (p = 0.02), and 28.0 years (range, 13-60 yr) in black patients (p = 0.08). Patients aged >40 years at TA onset were more frequently white than non-white (40.0% vs. 18.6%, p = 0.03). North African patients had more frequent occurrence of ischemic stroke (p = 0.03) and poorer survival (p = 0.01) than white patients. Type V of the Hata classification was the most frequent type among white (38.5%), North African (65.0%), and black patients (40.0%). Corticosteroids were used in 96.1% of patients. Fifty-three percent of white and North African patients, and 44% of black patients required a second line of immunosuppressive treatment (p = 0.60). Vascular surgical procedures were respectively performed in 46.1%, 50.0%, and 55.0% of white, North African, and black patients, p = 0.81. The 5-year and 10-year survival rates were 100% and 95.0%, respectively, in white patients; 67.4% at both 5 years and 10 years in North African patients; and 100% at both 5 years and 10 years in black patients. This study is one of the first direct comparisons of TA profiles among patients of distinct ethnic backgrounds. Our data support the idea that late-onset TA or an overlap between TA and large-vessel giant cell arteritis may be observed in white patients. North African patients have a higher occurrence of ischemic stroke and poorer survival than white patients.
authors.affiliation: From Service de Médecine Interne (LA, JH, NL, NCC, DB, P Cacoub, JCP, ZA), Service de Radiologie (DT, P Cluzel), Service de Santé Publique (LG), and Service de Chirurgie Vasculaire (FK, EK); and Hôpital Pitié-Salpêtrière, AP-HP, Université Paris 6, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Arnaud
authors.forename: Julien
authors.initials: J
authors.lastname: Haroche
authors.forename: Nicolas
authors.initials: N
authors.lastname: Limal
authors.forename: Dan
authors.initials: D
authors.lastname: Toledano
authors.forename: Laetitia
authors.initials: L
authors.lastname: Gambotti
authors.forename: Nathalie Costedoat
authors.initials: NC
authors.lastname: Chalumeau
authors.forename: Du Le Thi Huong
authors.initials: DLTH
authors.lastname: Boutin
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.forename: Philippe
authors.initials: P
authors.lastname: Cluzel
authors.forename: Fabien
authors.initials: F
authors.lastname: Koskas
authors.forename: Edouard
authors.initials: E
authors.lastname: Kieffer
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Piette
authors.forename: Zahir
authors.initials: Z
authors.lastname: Amoura
mesh_terms: D000293:Adolescent; D000328:Adult; D000352:Africa, Northern / Q000453:epidemiology / Q000208:ethnology; D000368:Aged; D044383:Black People; D005260:Female; D005602:France / Q000453:epidemiology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000188:drug therapy* / Q000453:epidemiology* / Q000208:ethnology; D016896:Treatment Outcome; D044465:White People
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents