Imaging modalities for the diagnosis and disease activity assessment of Takayasu's arteritis: A systematic review and meta-analysis

Barra, Lillian; Kanji, Tahir; Malette, Jacqueline; Pagnoux, Christian; CanVasc,

doi:10.1016/j.autrev.2017.11.021

Cited by 118 publications

(112 citation statements)

References 56 publications

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“…Type V and type IV are unequivocally the most frequently reported angiographic involvement patterns in previously published studies regarding childhood‐onset Takayasu arteritis . Similar to other case series, in our study the most common type of involvement pattern was type IV followed by type V with respect to Numano's angiographic classification.…”

Section: Discussionsupporting

confidence: 88%

“…Childhood‐onset Takayasu arteritis is reported to be a more refractory disease with lower rates of remissions compared to adult counterparts . Assessment of disease activity and treatment response is still the most difficult challenge for clinicians . There are limited data on clinical features, assessment of disease activity and long‐term outcome of Takayasu arteritis in children.…”

Section: Introductionmentioning

confidence: 99%

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Childhood‐onset Takayasu arteritis: A 15‐year experience from a tertiary referral center

et al. 2018

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Childhood‐onset Takayasu arteritis: A 15‐year experience from a tertiary referral center

et al. 2018

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“…However, a recent systematic review confirmed variable sensitivity and specificity of either computed tomographic angiography (CTA) or MRA for disease activity assessment in TA . Positron emission tomography CT (PET‐CT) had a pooled sensitivity of 81% and specificity of 74% to detect active TA, and recent literature suggests that this modality may identify a distinct population of active TA in whom traditional inflammatory markers like CRP are not raised . A recent meta‐analysis of nine published studies reporting the use of PET‐CT in TA confirmed only a modest association of CRP elevations with PET‐CT positivity, lending further credence to the above hypothesis .…”

Section: Takayasu Arteritismentioning

confidence: 98%

“…Angiography is critical to the diagnosis of TA, and recent guidelines for imaging of LVV from the European League against Rheumatism (EULAR) recommend magnetic resonance angiography (MRA) as the first line modality for imaging and assessing wall thickening to assess disease activity in TA . However, a recent systematic review confirmed variable sensitivity and specificity of either computed tomographic angiography (CTA) or MRA for disease activity assessment in TA . Positron emission tomography CT (PET‐CT) had a pooled sensitivity of 81% and specificity of 74% to detect active TA, and recent literature suggests that this modality may identify a distinct population of active TA in whom traditional inflammatory markers like CRP are not raised .…”

Section: Takayasu Arteritismentioning

confidence: 99%

Vasculitis research: Current trends and future perspectives

et al. 2018

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We discuss recent and prospective research in small and large vessel vasculitis. Large cohorts of Takayasu arteritis (TA) have been recently published from across the world, clarifying our understanding of this uncommon disease. Novel open-ended approaches like large-scale genotyping, proteomics and metabolomics have helped gain novel insights into TA, giant cell arteritis (GCA) and anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). Recent advances in the imaging of TA and GCA offer promise for earlier diagnosis and better monitoring of response to therapy. Although two randomized controlled trials of abatacept and tocilizumab failed to meet their primary end-points, successful large-scale studies of abatacept and tocilizumab in GCA hold promise for better disease control. While cyclophosphamide has revolutionized the management of AAV, increasing use of rituximab as an alternative induction regimen, as well as use of novel approaches involving reduced or no corticosteroid use for AAV and alternative agents such as avacopan (a complement 5a receptor antagonist) hold promise for lesser toxic induction regimens in the future. Increasingly, the risk of cardiovascular events and comorbidities such as osteoporosis are being recognized as factors affecting long-term prospects of patients with vasculitis. There is a shift in emphasis to utilize patient-reported outcomes to more accurately gauge the impact of vasculitides and their treatment.

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“…Patients with HLA-B52 have susceptibility to Takayasu arteritis, and those with leukocyte antigen Bw52 have a higher rate of complications than those without [80]. Doppler ultrasound (US), magnetic resonance angiograph (MRA), computed tomography angiograph (CTA), and 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) have the potential to replace conventional X-ray angiography as noninvasive diagnostic method [Barra 2018] [82]. 18 F-FDG-PET is helpful in the setting of absent vascular symptoms, fever of unknown origin, or unexplained acute-phase response.…”

Section: Takayasu Arteritismentioning

confidence: 99%