Prognostic significance and rationality of regular non-invasive imaging follow-up in Takayasu arteritis: A large multicenter cohort study

Abstract

Objectives: To investigate the prognostic significance of regular imaging follow-up in Takayasu arteritis (TAK) and assess its rationality.

Methods: This was a retrospective multicenter cohort study. A total of 204 adult patients with TAK from 11 tertiary centers, and 580 imaging studies of these patients were included to encompass all concurrent clinical and laboratory findings.

Results: The median follow-up time was 72 (36-96) months. Radiological activity and/or progression was observed in 116 (20 %) of the 580 imaging. A total of 418 (72 %) of the 580 imaging were performed while the physician's global assessment (PGA) was inactive. Radiological activity and/or progression was observed in only 18 (4 %) of the PGA inactive imaging. Younger age [OR 0.980; 95 % CI: 0.961-0.999, P = 0.041] and active PGA [OR 31.766; 95 % CI: 17.961-56.219, P < 0.001] were predictors of radiological activity and/or progression. There was no difference in terms of disease outcomes (MACE, VDI score, and mortality) between patients who underwent regular imaging follow-up regardless of clinical activity once a year or more and others.

Conclusion: In the absence of clinical activity, the rate of radiological activity and/or progression is very low in patients with TAK during routine follow-up. It seems more reasonable to develop a personalised imaging follow-up plan that takes clinical activity findings into account rather than regular imaging follow-up.

Keywords: Imaging follow-up; Mortality; Prognosis; Takayasu Arteritis.