The Epidemiology of Takayasu Arteritis in Rio de Janeiro, Brazil

Abstract

Objective Few population-based studies for Takayasu arteritis (TAK) have been performed, and Latin America prevalence/incidence data are unavailable. We aimed to understand TAK epidemiology in Rio de Janeiro City in 2020 (i.e., 6,747,815 inhabitants). Methods This was a cross-sectional fieldwork study where physicians who regularly followed TAK patients in public or private practices from Rio de Janeiro were invited to complete a REDCap survey. Patients should fulfill internationally accepted criteria for TAK and be living in the city. The 2020 prevalence was calculated as cases per 1,000,000 inhabitants (106). National government databases were analyzed for comparative prevalence assessment. The incidence rate was estimated using retrospective sections of cases diagnosed between 2010 and 2019; relative incidence risk was assessed by Poisson regression models with robust variance. Results Between May 2020 and May 2021, 114 patients were analyzed. Ninety-seven (85.1%) were female, and the most frequent races were White (44.7%), Mestizo (33.3%), and Black (16.7%). Takayasu arteritis 2020 prevalence was 16.9 cases/106 (95% confidence interval [CI], 14.1–20.3 cases/106); female patients and Black Brazilians had higher prevalence rates at 27.0 (95% CI, 22.2–33.3) and 25.1 cases/106 (95% CI, 16.1–39.3 cases/106), respectively. Government databases' analyses generated a lower prevalence (7.26 cases/106; 95% CI, 5.49–9.60 cases/106). The 2010–2019 mean incidence rate was 0.94 cases/106 per year (95% CI, 0.73–1.21 cases/106). Female patients had a higher risk than male patients of having TAK between 2010 and 2019 (relative risk, 2.70; 95% CI, 1.59–4.55; p < 0.0001). Conclusion In the largest population-based fieldwork to date and the first Latin American study on TAK prevalence, Rio de Janeiro City in 2020 showed an intermediate prevalence between Europe and Asia. Female patients and Black Brazilians were more affected than the general population.

Pan American League of Associations for Rheumatology Guidelines for the Treatment of Takayasu Arteritis

“…[6][7][8] In Rio de Janeiro, the prevalence of TAK has been estimated to be 16.9 cases per million people. 9 In contrast, TAK seems to be less frequent in Peru and comprised only 6.9% of the systemic vasculitides diagnosed in a Peruvian vasculitis referral center. 7 Takayasu arteritis is a difficult condition to manage because of the lack of accurate biomarkers to monitor disease activity, the possibility of subclinical vascular inflammation, and the paucity of randomized controlled trials to guide therapy.…”

“…Whereas the epidemiology of TAK has not been characterized in most regions of Latin America, studies from Colombia and Southeast Brazil showed that TAK was the first and the second most frequent primary vasculitis diagnosed in tertiary hospitals, respectively 6–8 . In Rio de Janeiro, the prevalence of TAK has been estimated to be 16.9 cases per million people 9 . In contrast, TAK seems to be less frequent in Peru and comprised only 6.9% of the systemic vasculitides diagnosed in a Peruvian vasculitis referral center 7 …”

Effectiveness and safety of adalimumab compared with leflunomide in patients with Takayasu arteritis: a retrospective cohort study

“… 1 TAK is a rare disease with a worldwide distribution whose prevalence ranges from 0.9 cases/1 000 000 in the USA to 40 cases/1 000 000 in Japan 2 ; recently, the prevalence of TAK in Brazil was reported as 16.9 cases/1 000 000. 3 As a rare disease, the assessment of therapeutic agents for TAK by clinical trials is a challenge and only a few clinical trials have analysed available therapies. 4 5 Currently, the management of TAK is based mostly on the results of non-randomised case series.…”