Patients with Takayasu arteritis at risk for aneurysmal disease

Several patients with Takayasu arteritis (TA) have been shown to have aneurysmal disease, reveals a recent study.

Seventy-four patients with TA at the Mount Sinai Hospital Vasculitis Clinic in Toronto, Canada, were enrolled in this single-centre retrospective study. TA diagnosis was based on clinical findings or satisfied the 1990 American College of Rheumatology classification criteria.

Aneurysmal disease was diagnosed in 23 patients (23 percent), with a median disease duration of 9.0 years. Prior hypertension (p=0.02), fever (p=0.04), and seizure disorders (p=0.03) were common among TA patients, while limb claudication was less frequent (p=0.01).

Twenty-two of the 23 patients exhibited persistent or new aneurysms during follow-up. Of the 22 patients, 13 had thoracic aorta aneurysm, eight had abdominal aorta, seven had subclavian, and six had carotid artery disease. Aortic valve regurgitation was also more frequent (9/23 vs 3/48; p=0.001).

Glucocorticoids were administered to 21 patients (median 6.1 years), while methotrexate, azathioprine, and leflunomide were used constantly. Seven patients used infliximab (p=0.04), while only four with aneurysmal disease received tocilizumab (p=0.01). Additionally, those with aneurysms experienced more frequent relapses (2.0 vs 1.0; p=0.04).

“Given that aneurysms may carry a risk of rupture and are associated with a higher rate of relapse, this finding should be reported systematically in TA studies,” the researchers said.

TA may result in stenotic disease, while aneurysmal lesions are rarer, according to the researchers.