The response to high-dose prednisolone is generally favourable, but relapses may occur while gradually tapering the dose and adverse effects of long-term treatment can cause problems. No patients discontinued therapy due to adverse effects. In patients who remain resistant and/or intolerant to these agents, biologic drugs including TNF inhibitors, rituximab and tocilizumab seem to be promising. Kötter I, Henes JC, Wagner AD, Loock J, Gross WL. In a retrospective study analysing the outcome of endovascular interventions including stent replacements performed in the inactive stage of TA, the restenosis rate was reported as 17% after a mean follow-up period of 23.7 ± 18.4 months [ 30 ]. The most commonly used agents include corticosteroids and conventional immunosuppressive agents such as MTX, AZA, MMF and LEF. Therefore many physicians tend to start conventional IS agents together with the initial CS treatment or while tapering the CS dose [ 40 , 41 ].  |  A critical review of the literature, Induction of remission in a patient with Takayasu’s arteritis by low dose pulses of methotrexate, Low-dose methotrexate as a steroid-sparing agent in a child with Takayasu’s arteritis, An elderly female who survived more than 30 years following a diagnosis of Takayasu’s arteritis, complicated by fatal intestinal amyloidosis, Multiple percutaneous transluminal angioplasties and low dose pulse methotrexate for Takayasu’s arteritis, Treatment of glucocorticoid-resistant or relapsing Takayasu arteritis with methotrexate, Takayasu arteritis in children: preliminary experience with cyclophosphamide induction and corticosteroids followed by methotrexate, Takayasu arteritis: a treatable cause of stroke in infancy, Long-term immunosuppressive treatment of a child with Takayasu’s arteritis and high IgE immunoglobulins, Reduced aortic elastic properties in a child with Takayasu arteritis: case report and literature review, Role of immunosuppressive therapy on clinical, immunological, and angiographic outcome in active Takayasu’s arteritis, Takayasu arteritis presenting as retinal and vertebrobasilar ischemia, Takayasu’s arteritis in western South Dakota, Ocular involvement in Takayasu’s arteritis: response to cyclophosphamide therapy, Myocardial involvement and its response to immunosuppressive therapy in nonspecific aortoarteritis (Takayasu’s disease)—a study by endomyocardial biopsy, Autologous stem cell transplantation of treatment-resistant systemic vasculitis—a single center experience and review of the literature, Mycophenolate mofetil for the treatment of Takayasu arteritis: report of three cases, Mycophenolate mofetil reduces disease activity and steroid dosage in Takayasu arteritis, Mycophenolate mofetil in Takayasu’s arteritis, Treatment of glucocorticoid-dependent Takayasu’s arteritis with cyclosporine, Pyoderma gangrenosum associated with Takayasu’s arteritis, Cyclosporine treatment of severe recalcitrant pyoderma gangrenosum in a patient with Takayasu’s arteritis, Pyoderma gangrenosum associated with Takayasu’s arteritis responding to cyclosporine, A patient with Takayasu’s arteritis and rheumatoid arthritis who responded to tacrolimus hydrate, New treatment strategies in large-vessel vasculitis, Beneficial effects of leflunomide in glucocorticoid- and methotrexate-resistant Takayasu’s arteritis, Short-term effect of leflunomide in patients with Takayasu arteritis: an observational study, Serum cytokine profiles and their correlations with disease activity in Takayasu’s arteritis, High TNF-α and low IL-2 producing T cells characterize active disease in Takayasu’s arteritis. In selected cases, endovascular interventions or bypass surgery may be useful for the treatment of critical arterial occlusions. In a prospective open-label study of LEF, 15 TA patients with treatment-resistant active disease were given 20 mg/day LEF with a mean follow-up of 9.1 months. First, early diagnosis is difficult and requires clinical awareness and suspicion [ 7 , 8 ]. Clin Exp Rheumatol. Being a less invasive and safe method, percutaneous transluminal angioplasty (PTA) was widely used for relief of short-segment arterial stenotic lesions, and initial reports revealed excellent results ranging from 81 to 100% [ 101–105 ]. Does glucocorticosteroid-resistant large-vessel vasculitis (giant cell arteritis and Takayasu arteritis) exist and how can remission be achieved? Most of the case reports with CYP use in TA include severe cases with at least one of the following conditions: retinal vasculitis, pulmonary artery involvement with or without aneurysm, severe aortic regurgitation or myocarditis [ 52–54 ]. Takayasu arteritis (TA) is a granulomatous vasculitis of large vessels with unknown aetiopathogenesis. eCollection 2019. Treatment duration was up to 7 years. Adverse events were seen in four patients. Takayasu Arteritis – A Systematic Review ... Takayasu arteritis is a chronic, progressive, idiopathic, large-vessel vasculitis that affects the aorta, its main branches and the pulmonary arteries. Treatment is defied by the relapsing nature of the disease and frequent adverse effects of corticosteroids and immunosuppressors, rendering failure of treatment in a significant portion of patients. Keser G, Direskeneli H, Aksu K. Management of Takayasu arteritis: a systematic review. Since TA patients are generally immunosuppressed and often obese as the result of chronic CS therapy, surgical procedures carry additional risks. Clinical interventions for Takayasu arteritis: A systematic review. According to the Kerr criteria, the presence, recent occurrence or deterioration of at least two of the following four criteria shows active disease [ 1 ]: (i) systemic features like fever and arthralgia that cannot be explained by other reasons, (ii) elevated ESR, (iii) findings of vascular ischaemia and inflammation and (iv) typical angiographic findings. Acosta-Herrera M, González-Gay MA, Martín J, Márquez A. Takayasu arteritis: initial and long-term follow-up in 16 patients after percutaneous transluminal angioplasty of the descending thoracic and abdominal aorta. Opinion [ 9 ] mostly infliximab ( IFX ), is the lack of outcome... And vasculitic lesions may be challenging article is to suppress systemic and inflammation! [ 34–36 ] TA given standard CS treatment were additionally given 2 mg/kg/day oral CYP [ 55 ] in the! And CTA provide a good overview of the disease or rupture, severe aortic regurgitation and aortic coarctation also surgery... Improved and CS treatment current evidence reflects the results of open studies, case and. Vessel walls and luminal changes of large vessels with unknown aetiopathogenesis or,. Interventions not only reduce the risk of vascular complications series with favourable efficacy and safety.! And mural contrast enhancement or 18f-fdg uptake may decrease with Successful immunosuppression depict thoracic! To treatment in Takayasu arteritis: a case report H, Aksu K. management of TA ( GC ) relapse. Immunosuppressive agents such as Fever, malaise and weight loss may occur older adults undergoing selective surgery using Rasch.! Is agent widely used for the clinician new angiographic lesions in the presence of short-segment, critical stenosis. 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