Improved prognosis of Takayasu arteritis over the past decade--comprehensive analysis of 106 patients.
BACKGROUND
We aimed to describe the recent clinical characteristics of Takayasu arteritis (TA).


RESULTS
We enrolled 106 consecutive TA patients and compared the clinical characteristics of patients with TA onset before 1999 and after 2000, patients with onset at age less than 39 years and more than 40 years, patients with monophasic and relapsing-remitting clinical course, and patients with and without human lymphocyte antigen (HLA)-B52 allele. Among the patients with TA onset after 2000, the time from onset to diagnosis had decreased; the frequency of occlusion in aortic arch branches and the complication of moderate or severe aortic regurgitation (AR) had decreased, and the maximum dose of prednisolone and the use of immunosuppressive agents had increased. In patients with onset at age more than 40 years, the complications of coronary artery lesions and hypertension had increased, and the incidence of moderate or severe AR had decreased. In the relapsing-remitting group, the maximum dose of prednisolone and the use of immunosuppressive agents had increased, and the mean dose reduction rate of prednisolone was significantly high. There was no significant difference between patients with and without HLA-B52 allele.


CONCLUSIONS
The prognosis of TA patients has improved over the past decade, which may be related to early diagnosis because of the development of noninvasive diagnostic imaging tools and improved medical treatments.
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Hirokazu
H
Ohigashi
Go
G
Haraguchi
Masanori
M
Konishi
Daisuke
D
Tezuka
Tetsuo
T
Kamiishi
Takashi
T
Ishihara
Mitsuaki
M
Isobe
D000328:Adult; D017668:Age of Onset; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000209:etiology; D001157:Arterial Occlusive Diseases / Q000209:etiology; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D059950:HLA-B52 Antigen / Q000032:analysis; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011239:Prednisolone / Q000008:administration & dosage; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013625:Takayasu Arteritis / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000401:mortality / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D055815:Young Adult
D005938:Glucocorticoids; D059950:HLA-B52 Antigen; D007166:Immunosuppressive Agents; D011239:Prednisolone