Remarkable damage along with poor quality of life in Takayasu arteritis: cross-sectional results of a long-term followed-up multicentre cohort

Clin Exp Rheumatol. Mar-Apr 2017;35 Suppl 103(1):77-82. Epub 2016 Nov 10.

Abstract

Objectives: 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.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Child
  • Cross-Sectional Studies
  • Cyclophosphamide / therapeutic use
  • Disease Progression
  • Drug Resistance
  • Female
  • Glucocorticoids / therapeutic use
  • Health Status
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Mental Health
  • Middle Aged
  • Quality of Life*
  • Risk Factors
  • Severity of Illness Index
  • Takayasu Arteritis / drug therapy
  • Takayasu Arteritis / pathology*
  • Takayasu Arteritis / psychology*
  • Time Factors
  • Treatment Outcome
  • Turkey
  • Young Adult

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Cyclophosphamide