title: Remarkable damage along with poor quality of life in Takayasu arteritis: cross-sectional results of a long-term followed-up multicentre cohort.
abstract: OBJECTIVE
  We aimed to assess the outcome of a large Takayasu arteritis (TAK) cohort using the vasculitis damage index (VDI) and quality of life (QoL) scale, tools which have been validated for vasculitis.
  
  
  METHODS
  Disease activity, damage and QoL were cross-sectionally evaluated in 165 TAK patients from 6 centres. SF-36 were applied to 51 age-matched healthy controls (HC). Persistent activity for ≥6 months was considered as treatment resistance (r-TAK). The correlation between VDI, clinical characteristics and mental (MCS)/physical (PCS) component scores of SF-36 were analysed. SF-36 and VDI scores were compared between TAK subgroups and HC.
  
  
  RESULTS
  The median age, follow-up time and disease duration were 40 (17-68), 60 (6-384), and 72 (6-396) months, respectively. 35% of them were r-TAK. VDI scores (VDIs) in TAK 4 (1-12) were mainly due to the disease itself [4 (1-10)]. VDIs in r-TAK were significantly higher than nr-TAK [5 (2-12) vs. 3 (2-10), p<0.001)]. In the TAK patients, MCS and PCS were found as 43±10 and 38±11, respectively. A high proportion of poor MCS (70%) and PCS (80%) were demonstrated in TAK. A significantly negative but weak correlation was observed between VDI and MCS (p=0.003, r=-0.23), PCS (p<0.001, r=-0.34). Higher VDIs were detected in patients with PCS <50 [5 (1-12) vs. 2 (1-6) p<0.001)]. SF-36 score was significantly lower in TAK than HC.
  
  
  CONCLUSIONS
  Disease-related damage mainly caused by peripheral vascular involvement was more predominant than treatment-related damage without reaching the level of severe damage scores, but contributing to poor QoL, in the TAK cohort.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Omma
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Turkey. burakerer@yahoo.com.
authors.forename: Burak
authors.initials: B
authors.lastname: Erer
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Medical Faculty, Ankara, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Karadag
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Marmara University, School of Medicine, Istanbul, Turkey.
authors.forename: Neslihan
authors.initials: N
authors.lastname: Yilmaz
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Marmara University, School of Medicine, Istanbul, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Alibaz-Oner
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Cukurova University, Medical Faculty, Adana, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Yildiz
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Ege University, School of Medicine, Izmir, Turkey.
authors.forename: Melike
authors.initials: M
authors.lastname: Kalfa
authors.affiliation: Division of Rheumatology, Dept. of Internal Medicine, Gaziantep University, Gaziantep Medical Faculty, Gaziantep, Turkey.
authors.forename: Gezmis
authors.initials: G
authors.lastname: Kimyon
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Medical Faculty, Ankara, Turkey.
authors.forename: Sedat
authors.initials: S
authors.lastname: Kiraz
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Marmara University, School of Medicine, Istanbul, Turkey.
authors.forename: Haner
authors.initials: H
authors.lastname: Direskeneli
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Cukurova University, Medical Faculty, Adana, Turkey.
authors.forename: Eren
authors.initials: E
authors.lastname: Erken
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Ege University, School of Medicine, Izmir, Turkey.
authors.forename: Kenan
authors.initials: K
authors.lastname: Aksu
authors.affiliation: Division of Rheumatology, Dept. of Internal Medicine, Gaziantep University, Gaziantep Medical Faculty, Gaziantep, Turkey.
authors.forename: Ahmet Mesut
authors.initials: AM
authors.lastname: Onat
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gül
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Lale
authors.initials: L
authors.lastname: Ocal
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Inanc
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Sevil
authors.initials: S
authors.lastname: Kamali
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D003520:Cyclophosphamide / Q000627:therapeutic use; D018450:Disease Progression; D004351:Drug Resistance; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006304:Health Status; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D013625:Takayasu Arteritis / Q000188:drug therapy / Q000473:pathology* / Q000523:psychology*; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide