AB0723 TAKAYASU ARTERITIS AND LARGE-VESSEL GIANT CELL ARTERITIS IN ITALIAN POPULATION. A RETROSPECTIVE COHORT STUDY

• Published in: Annals of the rheumatic diseases Vol. 82; no. Suppl 1; p. 1567
• Main Authors: Boiardi, L, Macchioni, P, Galli, E, Muratore, F, Csaali, M, Besutti, G, Spaggiari, L, Versari, A, Croci, S, Mancuso, P, P Giorgi Rossi, Marvisi, C, Gene, G, Salvarani, C
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.06.2023
• Subjects: Angina; Aorta; Arteritis; Cardiovascular diseases; Cohort analysis; Coronary vessels; Diagnosis; Femoral artery; Hypertension; Immunosuppressive agents; Inflammation; Literature reviews; Myocardial infarction; Occlusion; Patients; Polymyalgia rheumatica; Population studies; Prednisone; Remission; Renal artery; Skull; Stenosis; Takayasu's disease; Thorax; Vasculitis; Vein & artery diseases
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2023-eular.4496

BackgroundThere are few studies comparing clinical, laboratory, and imaging characteristics, and treatment of LV-GCA and TAK [1-3].ObjectivesTo compare clinical and imaging characteristics in patients with Takayasu arteritis (TAK) and large vessel-giant cell arteritis (LV-GCA) in an Italian population.MethodsWe conducted a retrospective monocenter study comparing characteristics and outcomes of a cohort of 59 patients with TAK and a cohort of 127 patients with LV-GCA diagnosed between 1996 and 2016 and followed up for at least 24 months at Reggio Emilia Hospital (Italy).ResultsLV-GCA patients had a higher prevalence of males (p=0.003), and more frequently presented with cranial symptoms (p=0.001), fever>38°C (p=0.007), polymyalgia rheumatica (p=0.001), and hypertension.(p=0.001), and they had higher ESR levels at diagnosis (p=0.0001). Differently, TAK patients had longer delay to diagnosis from the beginning of symptoms (p=0.048), they presented more frequently with loss of pulses of large arteries (p=0.0001), vascular bruits (p=0.001), limb claudication (p=0.003), myocardial infarction/angina (p=0.03), and hypertension induced by renal artery stenosis (p=0.001). Regarding treatment, TAK patients received a higher total and at 1 year cumulative prednisone doses (0.0001 and 0.001, respectively), they had a longer duration of prednisone therapy (p=0.008), and received during follow-up more frequently traditional immunosuppressants (p=0.0001) and biological agents (p=0.0001). Flares were more frequently observed in TAK patient (p=0.001), while no differences were observed for long-term remission. New vascular procedures during the follow-up were more frequently performedin TAK.patients (p=0.0001). Regarding imaging at diagnosis, TAK patients had more frequently vascular stenosis/occlusion (p=0.0001) and a higher number of vessels with structural damage per person (p=0.0001), while LV-GCA patients had a higher number of inflamed vessels per person (p=0.0001).Comparing the involved vascular districts at diagnosis for the presence of vessel inflammation and/or arterial damage, patients with LV-GCA had a more frequent involvement of thoracic and abdominal aorta (p=0.024 and p=0.007, respectively), and axillary, iliac and femoral arteries (p=0.018, p=0.002, and p=0.0001. respectively), while in TAK patients, brachiocephalic, celiac, mesenteric and renal arteries were more frequently involved (p=0.011, p=0.019, p=0.019, and p=0.005, respectively). At imaging arterial damage at diagnosis was more frequently observed in TAK patients, specifically at common carotid, brachiocephalic, and subclavian arteries (p=0.0001, p=0.006, p=0.0001, respectively) and descending aorta.(p=0.022). Regarding imaging during the follow-up, TAK patients developed more frequently new vascular stenosis/occlusion (p=0.0001) and new vascular thickening (p=0.002), no differences were observed for the development of new dilatation/aneurysm between the two vasculitis. In the literature review, we identified 7 papers comparing clinical and imaging characteristics of LV-GCA and TAK. Similarities and differences were found comparing our results with those of previous studies.ConclusionPatients with TAK and LV-GCA show a number of similarities and also differences. Indeed, it is unclear whether they are part of the same disease spectrum or they are different conditions. As more information regarding the pathogenesis and etiology becomes known, answers to these questions are like to be forthcoming.References[1]Furuta S et al Clinical features and radiological findings in large vessel vasculitis: are Takayasu arteritis and giant cell arteritis 2 different diseases or a single entity? J Rheumatol. 2015; 42: 300-8.[2]Kermani TA et al Extra-cranial giant cell arteritis and Takayasu arteritis: How similar are they? Semin Arthritis Rheum. 2015; 44: 724-8.[3]Vautier M et al. Prognosis of large vessel involvement in large vessel vasculitis. J Autoimmun. 2020; 108: 102419.Acknowledgements:NIL.Disclosure of InterestsNone Declared.