title: Assessment of disease activity and progression in Takayasu's arteritis with Disease Extent Index-Takayasu.
abstract: OBJECTIVE
  Disease Extent Index-Takayasu (DEI.Tak) is a new index developed for the follow-up of Takayasu's arteritis (TA), assessing only clinical findings without the requirement of imaging. We investigated the effectiveness of DEI.Tak in assessing disease activity and progression by comparing with physician's global assessment (PGA) and active disease criteria defined by Kerr et al.
  
  
  METHODS
  The initial DEI.Tak forms were filled in for 145 TA patients cross-sectionally to detect the baseline damage and after 29.8 (31) months (n = 105, 144 visits) only by including the new/worsening symptoms within the past 6 months.
  
  
  RESULTS
  At baseline, all patients had a DEI.Tak >0 [mean (s.d.): 7.6 (4.2)]. At this evaluation, 62% of the patients had active, 16.2% had persistent and 21.8% had inactive disease according to the PGA. At follow-up, in 69% of the patients the DEI.Tak score was 0. However, 14% of them were accepted as having active and 17% persistent disease according to PGA. In contrast, 18% with a DEI.Tak  ≥  1 were inactive according to PGA. Patients with active or persistent disease with PGA had higher DEI.Tak compared with inactives [1.3 (1.9), 1 (1.3) vs 0.2 (0.6), respectively; P < 0.001]. According to Kerr's criteria 27% were active. The total agreement between DEI.Tak and Kerr's criteria was 94% (κ = 0.85). Compared with PGA, Kerr's criteria had a total agreement of 74% and DEI.Tak 68%.
  
  
  CONCLUSIONS
  During follow-up, most TA patients showed no clinical activity with DEI-Tak. Although the agreement between Kerr's criteria and DEI.Tak seemed very good, using Kerr's criteria instead of DEI.Tak increased the consistency with PGA, which could be explained by the influence of imaging data and acute-phase reactant levels on the physician's decisions.
authors.affiliation: Marmara University Hospital, Rheumatology Department, Tophanelioglu cad. 13/15, 34662 Altunizade, Istanbul, Turkey. drsibelaydin@gmail.com
authors.forename: Sibel Z
authors.initials: SZ
authors.lastname: Aydin
authors.forename: Neslihan
authors.initials: N
authors.lastname: Yilmaz
authors.forename: Servet
authors.initials: S
authors.lastname: Akar
authors.forename: Kenan
authors.initials: K
authors.lastname: Aksu
authors.forename: Sevil
authors.initials: S
authors.lastname: Kamali
authors.forename: Eftal
authors.initials: E
authors.lastname: Yucel
authors.forename: Omer
authors.initials: O
authors.lastname: Karadag
authors.forename: Muge
authors.initials: M
authors.lastname: Bicakcigil
authors.forename: Huseyin
authors.initials: H
authors.lastname: Ozer
authors.forename: Sedat
authors.initials: S
authors.lastname: Kiraz
authors.forename: Fatos
authors.initials: F
authors.lastname: Onen
authors.forename: Murat
authors.initials: M
authors.lastname: Inanc
authors.forename: Gokhan
authors.initials: G
authors.lastname: Keser
authors.forename: Nurullah
authors.initials: N
authors.lastname: Akkoc
authors.forename: Haner
authors.initials: H
authors.lastname: Direskeneli
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000792:Angiography / Q000379:methods; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013625:Takayasu Arteritis / Q000503:physiopathology*; D013997:Time Factors; D055815:Young Adult