Uchida Haruhito A, Nakaoka Yoshikazu, Sugihara Takahiko, Yoshifuji Hajime, Maejima Yasuhiro, Watanabe Yoshiko, Nagafuchi Hiroko, Okazaki Takahiro, Komagata Yoshinori, Tanaka Yoshiya, Amiya Eisuke, Atsumi Tatsuya, Tanemoto Kazuo, Takeuchi Tsutomu, Naniwa Taio, Komatsuda Atsushi, Dobashi Hiroaki, Amano Koichi, Ogawa Noriyoshi, Murakawa Yohko, Hasegawa Hitoshi, Hayashi Taichi, Arimura Yoshihiro, Isobe Mitsuaki, Harigai Masayoshi
Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science.
Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute.
Circ J. 2025 Apr 25;89(5):612-619. doi: 10.1253/circj.CJ-24-0178. Epub 2024 Sep 12.
This study aimed to clarify recent clinical features and treatment outcomes in Japanese patients with newly diagnosed Takayasu arteritis (TAK) during the first 2 years of treatment.
A nationwide multicenter retrospective cohort study for TAK was implemented to collect data between 2007 and 2014. The primary outcome of the study was clinical remission at Week 24. Of the 184 participants registered, 129 patients with newly diagnosed TAK were analyzed: 84% were female and the mean age at onset was 35 years. Clinical symptoms at diagnosis were mostly associated with large-vessel lesions. Frequent sites of vascular involvement included the carotid artery, subclavian artery, aortic arch, and descending aorta. The mean initial dose of prednisolone administered was 0.68 mg/kg/day, and 59% and 17% of patients received immunosuppressive drugs and biologics, respectively, by Week 104. Clinical remission at Week 24 and sustained clinical remission with daily prednisolone at ≤10 mg at Week 52 were achieved in 107 (82.9%) and 51 (39.5%) patients, respectively. The presence of signs and symptoms linked to large-vessel lesions was associated with failure to achieve sustained clinical remission at Week 52.
We elucidated the clinical characteristics, treatment outcomes, and factors associated with failure to achieve sustained clinical remission in patients with newly diagnosed TAK in Japan during the first 2 years of treatment.
本研究旨在阐明日本新诊断的大动脉炎（TAK）患者在治疗的前两年中的近期临床特征和治疗结果。
开展了一项全国多中心TAK回顾性队列研究，以收集2007年至2014年的数据。该研究的主要结局是第24周时的临床缓解。在登记的184名参与者中，对129例新诊断的TAK患者进行了分析：84%为女性，发病时的平均年龄为35岁。诊断时的临床症状大多与大血管病变相关。血管受累的常见部位包括颈动脉、锁骨下动脉、主动脉弓和降主动脉。泼尼松龙的平均初始剂量为0.68mg/kg/天，到第第104周时，分别有59%和17%的患者接受了免疫抑制药物和生物制剂治疗。分别有107例（82.9%）和51例（39.5%）患者在第24周时实现了临床缓解，在第52周时实现了每日泼尼松龙剂量≤10mg的持续临床缓解。与大血管病变相关的体征和症状的存在与第52周时未实现持续临床缓解有关。
我们阐明了日本新诊断的TAK患者在治疗的前两年中的临床特征、治疗结果以及与未实现持续临床缓解相关的因素。
