ABSTRACT

Assessment of disease activity has a critical role in the follow-up of Takayasu’s arteritis (TAK). However, disease activity indices that have been developed so far have not been widely accepted to assess disease activity in TAK. The physician’s global assessment, which evaluates symptoms of systemic inflammation, physical examination findings, acute phase reactants, and arterial findings on imaging, is frequently used by clinicians during routine follow-up. Definition of active disease by the National Institute of Health is most frequently used in clinical studies. It is aimed to better define active disease with composite scores such as Indian Takayasu Arteritis score (ITAS) 2010, ITAS2010-A, in which acute phase response is also included, and ITAS2010-A-Rad, in which radiological evaluation is added. Magnetic resonance angiography, in which vessel wall inflammation and lumen can be evaluated, is recommended as the first imaging method in the diagnosis and follow-up of TAK. Conventional angiography is not recommended as the gold standard imaging method in the diagnosis of TAK. Although there has been an improvement in prognosis with decreasing mortality rates in TAK follow-up, significant damage has been reported even at the diagnostic period due to the delay in diagnosis. Both disease-related and treatment-related damage should be evaluated together in the follow-up of TAK patients. Few parameters in the vasculitis damage index, which was developed for damage assessment in systemic vasculitides, can be applied to TAK patients. The Takayasu Arteritis Damage score is a damage score that aims to assess damage only in TAK patients. The Large Vessel Vasculitis Damage index, which aims to assess damage specific to large vessel vasculitides (LVV), is under development. A Delphi exercise with experts was completed by the OMERACT “large vessel vasculitides working group” and efforts are ongoing to develop a core outcome set.