Takayasu arteritis: advanced understanding is leading to new horizons

Rheumatology (Oxford). 2019 Feb 1;58(2):206-219. doi: 10.1093/rheumatology/key040.


Although outcomes in Takayasu arteritis (TAK) are improving, diagnosis is typically delayed and significant arterial injury accrues. While wider use of non-invasive imaging is impacting this, the onus remains with clinicians to consider a diagnosis of TAK earlier. Meanwhile, morbidity and mortality in TAK remains increased. Herein we review the current situation, outline recent advances and summarize remaining challenges. Understanding of disease pathogenesis remains poor. However, recent genetic data and identification of pathogenic cytokines may facilitate the search for biomarkers capable of distinguishing active and inactive disease, inflammatory and non-inflammatory arterial remodelling. Imaging is critical for TAK, and each modality has important strengths and limitations. Dependence upon CS therapy remains too high. However, the impact of combination immunosuppressive therapy is now recognized, biologic therapies are increasingly available and new agents offer promise. Multicentre clinical trials are now required, and these will depend upon development of defined clinical and imaging end-points.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antirheumatic Agents / therapeutic use
  • Biological Products / therapeutic use
  • Biomarkers / blood
  • Computed Tomography Angiography
  • Disease Progression
  • Genetic Predisposition to Disease
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Magnetic Resonance Angiography
  • Severity of Illness Index
  • Takayasu Arteritis / diagnosis*
  • Takayasu Arteritis / etiology
  • Takayasu Arteritis / therapy*


  • Antirheumatic Agents
  • Biological Products
  • Biomarkers
  • Immunosuppressive Agents