Photo Credit: Alena Butusava

The following is a summary of “Impact of conventional and biological disease-modifying anti-rheumatic drugs on arterial lesions in Takayasu arteritis,” published in the July 2024 issue of Rheumatology by Bletry et al.

The criteria for defining remission and disease activity in Takayasu arteritis (TAK) remain uncertain, with vascular imaging crucial for patient follow-up.

Researchers conducted a retrospective study comparing the progression of vascular lesions in patients with TAK treated with conventional disease-modifying anti-rheumatic drugs (cDMARDs) vs. biologic disease-modifying anti-rheumatic drugs (bDMARDs) using consistent CT angiography follow-up.

They compared 75 treatment therapies in patients with TAK, 40 patients receiving cDMARDs, and 35 patients receiving bDMARDs using CT angiography. The 1-3 primary vessels displaying vessel wall thickening and stenosis were designated target vessels. The vessel wall thickness and lumen diameter measurements were targeted at initiating immunosuppressive therapy after 12 months.

The result showed that most patients (73%) experienced a reduction in arterial wall thickness, with a significant decrease of more than 25% observed in cases (31%). First-line immunosuppressive therapy and bDMARDs compared to cDMARDs were linked to greater improvement (P-values of 0.012 and 0.026), and in vessels with stenosis immunosuppressive therapy led to a substantial diameter increase >25% in cases (38%). The improvement was even more pronounced with bDMARDs (56% vs. 17%) than for conventional DMARDs.

Investigators concluded that immunosuppressants, particularly bDMARDs, effectively improve arterial wall thickness and blood vessel diameter compared to cDMARDs in TAK.

Source: academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keae331/7708402