Anisha B Dua1, Mohamad A Kalot2, Nedaa M Husainat3, Kevin Byram4, Jason M Springer4, Karen E James5, Yih Chang Lin6, Marat Turgunbaev7, Alexandra Villa-Forte8, Andy Abril9, Carol Langford8, Mehrdad Maz10, Sharon A Chung11, Reem A Mustafa10. 1. Northwestern University Feinberg School of Medicine, Chicago, Illinois. 2. State University of New York at Buffalo. 3. St. Mary's Hospital, Saint Louis, Missouri. 4. Vanderbilt University Medical Center, Nashville, Tennessee. 5. University of Utah Health, Salt Lake City. 6. University of South Florida, Tampa. 7. American College of Rheumatology, Atlanta, Georgia. 8. Cleveland Clinic, Cleveland, Ohio. 9. Mayo Clinic, Jacksonville, Florida. 10. University of Kansas Medical Center, Kansas City. 11. University of California, San Francisco Medical Center.
Abstract
OBJECTIVE: Takayasu's arteritis (TAK) is a granulomatous large-vessel vasculitis primarily affecting the aorta and its proximal branches. TAK can be a difficult disease to diagnose and manage given the rarity of the disease as well as current limitations in biomarkers, imperfect imaging modalities, and few randomized controlled trials. METHODS: In developing the American College of Rheumatology/Vasculitis Foundation guideline for the management of TAK, we performed an extensive systematic literature review to guide our recommendations. We included RCTs first. When RCTs were not available, we included observational studies that reported on patient-important outcomes for the intervention and comparison. When studies with comparative data were not available, we included case series that present patient-important outcomes for either the intervention or the comparison. RESULTS: Three hundred forty-seven articles were included for full review to answer 27 population, intervention, comparison, and outcome questions related to TAK. Ten studies were evaluated that addressed the use of glucocorticoids (GCs), non-GC nonbiologic therapies, as well as biologics in treating TAK. A total of 33 studies, including 8 comparative studies, were included to determine the test accuracy of commonly available diagnostic tests for TAK. CONCLUSION: This comprehensive systematic review synthesizes and evaluates the benefits and harms of different treatment options and the accuracy of commonly used tests for the management of TAK.
OBJECTIVE:Takayasu's arteritis (TAK) is a granulomatous large-vessel vasculitis primarily affecting the aorta and its proximal branches. TAK can be a difficult disease to diagnose and manage given the rarity of the disease as well as current limitations in biomarkers, imperfect imaging modalities, and few randomized controlled trials. METHODS: In developing the American College of Rheumatology/Vasculitis Foundation guideline for the management of TAK, we performed an extensive systematic literature review to guide our recommendations. We included RCTs first. When RCTs were not available, we included observational studies that reported on patient-important outcomes for the intervention and comparison. When studies with comparative data were not available, we included case series that present patient-important outcomes for either the intervention or the comparison. RESULTS: Three hundred forty-seven articles were included for full review to answer 27 population, intervention, comparison, and outcome questions related to TAK. Ten studies were evaluated that addressed the use of glucocorticoids (GCs), non-GC nonbiologic therapies, as well as biologics in treating TAK. A total of 33 studies, including 8 comparative studies, were included to determine the test accuracy of commonly available diagnostic tests for TAK. CONCLUSION: This comprehensive systematic review synthesizes and evaluates the benefits and harms of different treatment options and the accuracy of commonly used tests for the management of TAK.