Advertisement

Pediatric Drugs

, Volume 21, Issue 2, pp 81–93 | Cite as

Childhood-Onset Takayasu Arteritis (c-TA): Current and Future Drug Therapy

  • Ruchika Goel
  • T. Sathish Kumar
  • Debashish DandaEmail author
Review Article
  • 21 Downloads

Abstract

Childhood-onset Takayasu arteritis (c-TA) is the third most common systemic vasculitic disorder in children. Vascular stenosis is the main complication, and aneurysms are reported in 19–65% of cases, often in combination with stenotic lesions. Management of patients with c-TA is largely based on studies involving predominantly patients with adult-onset TA (a-TA). More widely used criteria for patients with c-TA have been devised by the joint European League Against Rheumatism, Pediatric Rheumatology International Trials Organization, and Pediatric Rheumatology European Society. Of the available imaging modalities, those that do not use radiation (color Doppler ultrasound and magnetic resonance angiogram) are preferred over 18F-labeled fluoro-2-deoxyglucose (18F-FDG) positron-emission tomography, computed tomography (CT), and CT angiogram in children. Remission rates have been reported to be lower in c-TA than in a-TA, and published mortality rates in c-TA range from 16 to 40%, which is much higher than reported in patients with a-TA. The usual drug therapy options include steroids plus steroid-sparing second-line immunosuppressants, such as mycophenolate, azathioprine, methotrexate, cyclophosphamide, and cyclosporine, along with antiplatelet agents. Interleukin-6 inhibitors such as tocilizumab, as well as the tumor necrosis factor inhibitors, are other aggressive therapeutic options. As yet, no randomized controlled trials have been conducted in c-TA.

Notes

Compliance with Ethical Standards

Conflict of interest

RG, TSK, and DD have no conflicts of interest that are directly relevant to the content of this article.

Funding

No sources of funding were used to conduct this study or prepare this manuscript.

References

  1. 1.
    Kerr GS, Hallahan CW, Giordano J, Leavitt RY, Fauci AS, Rottem M, et al. Takayasu arteritis. Ann Intern Med. 1994;120(11):919–29.Google Scholar
  2. 2.
    Clemente G, Hilario MOE, Lederman H, Silva CA, Sallum AM, Campos LM, et al. Takayasu arteritis in a Brazilian multicenter study: children with a longer diagnosis delay than adolescents. Clin Exp Rheumatol. 2014;32(3 Suppl 82):S128–33.Google Scholar
  3. 3.
    Szugye HS, Zeft AS, Spalding SJ. Takayasu Arteritis in the pediatric population: a contemporary United States-based single center cohort. Pediatr Rheumatol Online J. 2014;12:21.Google Scholar
  4. 4.
    Brunner J, Feldman BM, Tyrrell PN, Kuemmerle-Deschner JB, Zimmerhackl LB, Gassner I, et al. Takayasu arteritis in children and adolescents. Rheumatol Oxf Engl. 2010;49(10):1806–14.Google Scholar
  5. 5.
    Goel R, Kumar TS, Danda D, Joseph G, Jeyaseelan V, Surin AK, et al. Childhood-onset Takayasu arteritis—experience from a tertiary care center in South India. J Rheumatol. 2014;41(6):1183–9.Google Scholar
  6. 6.
    Feng Y, Tang X, Liu M, Zhou J, Zhao X, Li Q. Clinical study of children with Takayasu arteritis: a retrospective study from a single center in China. Pediatr Rheumatol Online J. 2017;15(1):29.Google Scholar
  7. 7.
    Cakar N, Yalcinkaya F, Duzova A, Caliskan S, Sirin A, Oner A, et al. Takayasu arteritis in children. J Rheumatol. 2008;35(5):913–9.Google Scholar
  8. 8.
    McCulloch M, Andronikou S, Goddard E, Sinclair P, Lawrenson J, Mandelstam S, et al. Angiographic features of 26 children with Takayasu’s arteritis. Pediatr Radiol. 2003;33(4):230–5.Google Scholar
  9. 9.
    Ozen S, Ruperto N, Dillon MJ, Bagga A, Barron K, Davin JC, et al. EULAR/PReS endorsed consensus criteria* for the classification of childhood vasculitides. Ann Rheum Dis. 2006;65(7):936–41.Google Scholar
  10. 10.
    Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al. EULAR/PRINTO/PRES criteria for Henoch–Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis. 2010;69(5):798–806.Google Scholar
  11. 11.
    Maksimowicz-McKinnon K, Clark TM, Hoffman GS. Limitations of therapy and a guarded prognosis in an american cohort of takayasu arteritis patients. Arthritis Rheum. 2007;56(3):1000–9.Google Scholar
  12. 12.
    Matsuyama A, Sakai N, Ishigami M, Hiraoka H, Kashine S, Hirata A, et al. Matrix metalloproteinases as novel disease markers in Takayasu arteritis. Circulation. 2003;108(12):1469–73.Google Scholar
  13. 13.
    Dogan S, Piskin O, Solmaz D, Akar S, Gulcu A, Yuksel F, et al. Markers of endothelial damage and repair in Takayasu arteritis: are they associated with disease activity? Rheumatol Int. 2014;34(8):1129–38.Google Scholar
  14. 14.
    Alibaz-Oner F, Aksu K, Yentur SP, Keser G, Saruhan-Direskeneli G, Direskeneli H. Plasma pentraxin-3 levels in patients with Takayasu’s arteritis during routine follow-up. Clin Exp Rheumatol. 2016;34(3 Suppl 97):S73–6.Google Scholar
  15. 15.
    Ishihara T, Haraguchi G, Kamiishi T, Tezuka D, Inagaki H, Isobe M. Sensitive assessment of activity of Takayasu’s arteritis by pentraxin3, a new biomarker. J Am Coll Cardiol. 2011;57(16):1712–3.Google Scholar
  16. 16.
    Nair AM, Goel R, Hindhumati M, Jayakanthan K, Visalakshi J, Joseph G, et al. Serum amyloid A as a marker of disease activity and treatment response in Takayasu arteritis. Rheumatol Int. 2017;37(10):1643–9.Google Scholar
  17. 17.
    Goel R, Kabeerdoss J, Ram B, Prakash JAJ, Babji S, Nair A, et al. Serum Cytokine Profile in Asian Indian patients with Takayasu arteritis and its association with disease activity. Open Rheumatol J. 2017;11:23–9.Google Scholar
  18. 18.
    Alibaz-Oner F, Yentür SP, Saruhan-Direskeneli G, Direskeneli H. Serum cytokine profiles in Takayasu’s arteritis: search for biomarkers. Clin Exp Rheumatol. 2015;33(2 Suppl 89):S32–5.Google Scholar
  19. 19.
    Goel R, Kabeerdoss J, Mohan H, Danda S, Jayaseelan V, Kumar TS, et al. Soluble-HLA-E: a follow up biomarker in Takayasu arteritis, independent of HLA-E genotype. Int J Theuum Dis. 2018;21(2):532–40.Google Scholar
  20. 20.
    Tombetti E, Di Chio MC, Sartorelli S, Papa M, Salerno A, Bottazzi B, et al. Systemic pentraxin-3 levels reflect vascular enhancement and progression in Takayasu arteritis. Arthritis Res Ther. 2014;16(6):479.Google Scholar
  21. 21.
    Hoffman GS, Ahmed AE. Surrogate markers of disease activity in patients with Takayasu arteritis. A preliminary report from The International Network for the Study of the Systemic Vasculitides (INSSYS). Int J Cardiol. 1998;66(Suppl 1):S191–4 (discussion S195).Google Scholar
  22. 22.
    Ohigashi H, Haraguchi G, Konishi M, Tezuka D, Kamiishi T, Ishihara T, et al. Improved prognosis of Takayasu arteritis over the past decade. Circ J. 2012;76(4):1004–11.Google Scholar
  23. 23.
    Yoshida S, Akiba H, Tamakawa M, Yama N, Takeda M, Hareyama M, et al. The spectrum of findings in supra-aortic Takayasu’s arteritis as seen on spiral CT angiography and digital subtraction angiography. Cardiovasc Intervent Radiol. 2001;24(2):117–21.Google Scholar
  24. 24.
    Tso E, Flamm SD, White RD, Schvartzman PR, Mascha E, Hoffman GS. Takayasu arteritis: utility and limitations of magnetic resonance imaging in diagnosis and treatment. Arthritis Rheum. 2002;46(6):1634–42.Google Scholar
  25. 25.
    Tombetti E, Mason JC. Application of imaging techniques for Takayasu arteritis. Presse Médicale. 2017;46(7):e215–23.Google Scholar
  26. 26.
    Sun Y, Ma L, Ji Z, Zhang Z, Chen H, Liu H, et al. Value of whole-body contrast-enhanced magnetic resonance angiography with vessel wall imaging in quantitative assessment of disease activity and follow-up examination in Takayasu’s arteritis. Clin Rheumatol. 2016;35(3):685–93.Google Scholar
  27. 27.
    Sharma BK, Jain S, Radotra BD. An autopsy study of Takayasu arteritis in India. Int J Cardiol. 1998;66(Suppl 1):S85–90 (discussion S91).Google Scholar
  28. 28.
    Aggarwal A, Chag M, Sinha N, Naik S. Takayasu’s arteritis: role of Mycobacterium tuberculosis and its 65 kDa heat shock protein. Int J Cardiol. 1996;55(1):49–55.Google Scholar
  29. 29.
    Soto ME, Del Carmen Ávila-Casado M, Huesca-Gómez C, Alarcon GV, Castrejon V, Soto V, et al. Detection of IS6110 and HupB gene sequences of Mycobacterium tuberculosis and bovis in the aortic tissue of patients with Takayasu’s arteritis. BMC Infect Dis. 2012;12:194.Google Scholar
  30. 30.
    Saruhan-Direskeneli G, Biçakçigil M, Yilmaz V, Kamali S, Aksu K, Fresko I, et al. Interleukin (IL)-12, IL-2, and IL-6 gene polymorphisms in Takayasu’s arteritis from Turkey. Hum Immunol. 2006;67(9):735–40.Google Scholar
  31. 31.
    Terao C, Yoshifuji H, Kimura A, Matsumura T, Ohmura K, Takahashi M, et al. Two susceptibility loci to Takayasu arteritis reveal a synergistic role of the IL12B and HLA-B regions in a Japanese population. Am J Hum Genet. 2013;93(2):289–97.Google Scholar
  32. 32.
    Saruhan-Direskeneli G, Hughes T, Aksu K, Keser G, Coit P, Aydin SZ, et al. Identification of multiple genetic susceptibility loci in Takayasu arteritis. Am J Hum Genet. 2013;93(2):298–305.Google Scholar
  33. 33.
    Renauer P, Saruhan-Direskeneli G, Coit P, Adler A, Aksu K, Keser G, et al. Genome-wide association study identifies susceptibility loci in IL6, RPS9/LILRB3, and an intergenic locus on chromosome 21q22 in Takayasu’s arteritis. Arthritis Rheumatol. 2015;n/a – n/a.Google Scholar
  34. 34.
    Danda D, Goel R, Danda S, Mohan H, Joseph G, Kabeerdoss J, et al. Interleukin-17F and interleukin-6 gene polymorphisms in Asian Indian patients with Takayasu arteritis. Hum Immunol. 2017;78(7–8):515–20.Google Scholar
  35. 35.
    Arnaud L, Haroche J, Limal N, Toledano D, Gambotti L, Costedoat Chalumeau N, et al. Takayasu arteritis in France: a single-center retrospective study of 82 cases comparing white, North African, and black patients. Med (Baltimore). 2010;89(1):1–17.Google Scholar
  36. 36.
    Seko Y, Takahashi N, Tada Y, Yagita H, Okumura K, Nagai R. Restricted usage of T-cell receptor Vgamma-Vdelta genes and expression of costimulatory molecules in Takayasu’s arteritis. Int J Cardiol. 2000;75(Suppl 1):S77–83 (discussion S85–7).Google Scholar
  37. 37.
    Arnaud L, Haroche J, Mathian A, Gorochov G, Amoura Z. Pathogenesis of Takayasu’s arteritis: a 2011 update. Autoimmun Rev. 2011;11(1):61–7.Google Scholar
  38. 38.
    Saadoun D, Garrido M, Comarmond C, Desbois AC, Domont F, Savey L, et al. Th1 and Th17 cytokines drive Takayasu Arteritis inflammation. Arthritis Rheumatol Hoboken NJ. 2015.Google Scholar
  39. 39.
    Misra DP, Chaurasia S, Misra R. Increased circulating Th17 cells, serum IL-17A, and IL-23 in Takayasu arteritis. Autoimmune Dis. 2016;2016:7841718.Google Scholar
  40. 40.
    Tripathy NK, Sinha N, Nityanand S. Anti-annexin V antibodies in Takayasu’s arteritis: prevalence and relationship with disease activity. Clin Exp Immunol. 2003;134(2):360–4.Google Scholar
  41. 41.
    Wang H, Ma J, Wu Q, Luo X, Chen Z, Kou L. Circulating B lymphocytes producing autoantibodies to endothelial cells play a role in the pathogenesis of Takayasu arteritis. J Vasc Surg. 2011;53(1):174–80.Google Scholar
  42. 42.
    Hoyer BF, Mumtaz IM, Loddenkemper K, Bruns A, Sengler C, Hermann K-G, et al. Takayasu arteritis is characterised by disturbances of B cell homeostasis and responds to B cell depletion therapy with rituximab. Ann Rheum Dis. 2012;71(1):75–9.Google Scholar
  43. 43.
    Misra R, Aggarwal A, Chag M, Sinha N, Shrivastava S. Raised anticardiolipin antibodies in Takayasu’s arteritis. Lancet Lond Engl. 1994;343(8913):1644–5.Google Scholar
  44. 44.
    Wang X, Dang A, Lv N, Cheng N, Cheng X. Inflammation Is Associated With Platelet Coagulation Function Rather Than Enzymatic Coagulation Function in Patients With Takayasu Arteritis. Int Heart J. 2017;58(4):589–92.  https://doi.org/10.1536/ihj.16-533 Google Scholar
  45. 45.
    Ferfar Y, Mirault T, Desbois AC, Comarmond C, Messas E, Savey L, et al. Biotherapies in large vessel vasculitis. Autoimmun Rev. 2016;15(6):544–51.Google Scholar
  46. 46.
    Keser G, Direskeneli H, Aksu K. Management of Takayasu arteritis: a systematic review. Rheumatol Oxf Engl. 2014;53(5):793–801.Google Scholar
  47. 47.
    Ishikawa K, Maetani S. Long-term outcome for 120 Japanese patients with Takayasu’s disease. Clinical and statistical analyses of related prognostic factors. Circulation. 1994;90(4):1855–60.Google Scholar
  48. 48.
    Kötter I, Henes JC, Wagner AD, Loock J, Gross WL. Does glucocorticosteroid-resistant large-vessel vasculitis (giant cell arteritis and Takayasu arteritis) exist and how can remission be achieved? A critical review of the literature. Clin Exp Rheumatol. 2012;30(1 Suppl 70):S114–29.Google Scholar
  49. 49.
    Kong X, Ma L, Ji Z, Dong Z, Zhang Z, Hou J, et al. Pro-fibrotic effect of IL-6 via aortic adventitial fibroblasts indicates IL-6 as a treatment target in Takayasu arteritis. Clin Exp Rheumatol. 2018;36(1):62–72.Google Scholar
  50. 50.
    Tamura N, Maejima Y, Tezuka D, Takamura C, Yoshikawa S, Ashikaga T, et al. Profiles of serum cytokine levels in Takayasu arteritis patients: Potential utility as biomarkers for monitoring disease activity. J Cardiol. 2017;70(3):278–85.Google Scholar
  51. 51.
    Kötter I, Daikeler T, Amberger C, Tyndall A, Kanz L. Autologous stem cell transplantation of treatment-resistant systemic vasculitis–a single center experience and review of the literature. Clin Nephrol. 2005;64(6):485–9.Google Scholar
  52. 52.
    Liang GC, Nemickas R, Madayag M. Multiple percutaneous transluminal angioplasties and low dose pulse methotrexate for Takayasu’s arteritis. J Rheumatol. 1989;16(10):1370–3.Google Scholar
  53. 53.
    Mevorach D, Leibowitz G, Brezis M, Raz E. Induction of remission in a patient with Takayasu’s arteritis by low dose pulses of methotrexate. Ann Rheum Dis. 1992;51(7):904–5.Google Scholar
  54. 54.
    Hoffman GS, Leavitt RY, Kerr GS, Rottem M, Sneller MC, Fauci AS. Treatment of glucocorticoid-resistant or relapsing Takayasu arteritis with methotrexate. Arthritis Rheum. 1994;37(4):578–82.Google Scholar
  55. 55.
    Valsakumar AK, Valappil UC, Jorapur V, Garg N, Nityanand S, Sinha N. Role of immunosuppressive therapy on clinical, immunological, and angiographic outcome in active Takayasu’s arteritis. J Rheumatol. 2003;30(8):1793–8.Google Scholar
  56. 56.
    Goel R, Danda D, Mathew J, Edwin N. Mycophenolate mofetil in Takayasu’s arteritis. Clin Rheumatol. 2010;29(3):329–32.Google Scholar
  57. 57.
    De Souza AWS, da Silva MD, Machado LSG, Oliveira ACD, Pinheiro FAG, Sato EI. Short-term effect of leflunomide in patients with Takayasu arteritis: an observational study. Scand J Rheumatol. 2012;41(3):227–30.Google Scholar
  58. 58.
    De Souza AWS, de Almeida Agustinelli R, de Cinque Almeida H, Oliveira PB, Pinheiro FAG, Oliveira ACD, et al. Leflunomide in Takayasu arteritis—a long term observational study. Rev Bras Reumatol. 2016;56:371–5.Google Scholar
  59. 59.
    Fullerton SH, Abel EA, Getz K, El-Ramahi K. Cyclosporine treatment of severe recalcitrant pyoderma gangrenosum in a patient with Takayasu’s arteritis. Arch Dermatol. 1991;127(11):1731–2.Google Scholar
  60. 60.
    Ujiie H, Sawamura D, Yokota K, Nishie W, Shichinohe R, Shimizu H. Pyoderma gangrenosum associated with Takayasu’s arteritis. Clin Exp Dermatol. 2004;29(4):357–9.Google Scholar
  61. 61.
    Fearfield LA, Ross JR, Farrell AM, Costello C, Bunker CB, Staughton RC. Pyoderma gangrenosum associated with Takayasu’s arteritis responding to cyclosporin. Br J Dermatol. 1999;141(2):339–43.Google Scholar
  62. 62.
    Yokoe I, Haraoka H, Harashima H. A patient with Takayasu’s arteritis and rheumatoid arthritis who responded to tacrolimus hydrate. Intern Med Tokyo Jpn. 2007;46(22):1873–7.Google Scholar
  63. 63.
    Clifford A, Hoffman GS. Recent advances in the medical management of Takayasu arteritis: an update on use of biologic therapies. Curr Opin Rheumatol. 2014;26(1):7–15.Google Scholar
  64. 64.
    Mekinian A, Comarmond C, Resche-Regon M, Mirault T, Kahn JE, Lambert M, et al. Efficacy of biological-targeted treatments in takayasu arteritis: multicenter retrospective study of 49 patients. Circulation. 2015;132(18):1693–700.Google Scholar
  65. 65.
    Abisror N, Mekinian A, Lavigne C, Vandenhende M-A, Soussan M, Fain O, et al. Tocilizumab in refractory Takayasu arteritis: a case series and updated literature review. Autoimmun Rev. 2013;12(12):1143–9.Google Scholar
  66. 66.
    Pazzola G, Muratore F, Pipitone N, Crescentini F, Cacoub P, Boiardi L, et al. Rituximab therapy for Takayasu arteritis: a seven patients experience and a review of the literature. Rheumatology (Oxford). 2017;57(7):1151–5.  https://doi.org/10.1093/rheumatology/kex249 Google Scholar
  67. 67.
    Langford CA, Cuthbertson D, Ytterberg SR, Khalidi N, Monach PA, Carette S, et al. A randomized, double-blind trial of abatacept (CTLA-4Ig) for the treatment of Takayasu arteritis. Arthritis Rheumatol Hoboken NJ. 2017;69(4):846–53.Google Scholar
  68. 68.
    Terao C, Yoshifuji H, Yukawa N, Nakajima T, Matsuda F, Mimori T. AB0636 Ustekinumab as a therapeutic option for Takayasu arteritis—from genetic findings to clinical application. Ann Rheum Dis. 2015;74(Suppl 2):1111–2.Google Scholar
  69. 69.
    Jales-Neto LH, Levy-Neto M, Bonfa E, de Carvalho JF, Pereira RMR. Juvenile-onset Takayasu arteritis: peculiar vascular involvement and more refractory disease. Scand J Rheumatol. 2010;39(6):506–10.Google Scholar
  70. 70.
    Aeschlimann FA, Barra L, Alsolaimani R, Benseler SM, Hebert D, Khalidi N, et al. Presentation and disease course of childhood- versus adult-onset Takayasu Arteritis. Arthritis Rheumatol. 2019;71(2):315–23.Google Scholar
  71. 71.
    Sahin S, Hopurcuoglu D, Bektas S, Belhan E, Adrovic A, Barut K, et al. Childhood-onset Takayasu arteritis: a 15-year experience from a tertiary referral center. Int J Rheum Dis. 2019;22(1):132–39.Google Scholar
  72. 72.
    Jain S, Sharma N, Singh S, Bali HK, Kumar L, Sharma BK. Takayasu arteritis in children and young indians. Int J Cardiol. 2000;31(75 Suppl 1):S153–7.Google Scholar
  73. 73.
    Morales E, Pineda C, Martínez-Lavín M. Takayasu’s arteritis in children. J Rheumatol. 1991;18(7):1081–4.Google Scholar
  74. 74.
    Ozen S, Duzova A, Bakkaloglu A, Bilginer Y, Cil BE, Demircin M, et al. Takayasu arteritis in children: preliminary experience with cyclophosphamide induction and corticosteroids followed by methotrexate. J Pediatr. 2007;150(1):72–6.Google Scholar
  75. 75.
    Misra DP, Aggarwal A, Lawrence A, Agarwal V, Misra R. Pediatric-onset Takayasu’s arteritis: clinical features and short-term outcome. Rheumatol Int. 2015;35(10):1701–6.Google Scholar
  76. 76.
    Eleftheriou D, Varnier G, Dolezalova P, McMahon A-M, Al-Obaidi M, Brogan PA. Takayasu arteritis in childhood: retrospective experience from a tertiary referral centre in the United Kingdom. Arthritis Res Ther. 2015;25(17):36.Google Scholar
  77. 77.
    Aeschlimann FA, Grosse-Wortmann L, Benseler SM, Laxer RM, Hebert D, Yeung RSM. Arterial dissection in childhood Takayasu Arteritis: not as rare as thought. Pediatr Rheumatol Online J. 2016;14(1):56.Google Scholar
  78. 78.
    Batu ED, Sönmez HE, Hazırolan T, Özaltın F, Bilginer Y, Özen S. Tocilizumab treatment in childhood Takayasu arteritis: case series of four patients and systematic review of the literature. Semin Arthritis Rheum. 2017;46(4):529–35.Google Scholar
  79. 79.
    Filocamo G, Buoncompagni A, Viola S, Loy A, Malattia C, Ravelli A, et al. Treatment of Takayasu’s arteritis with tumor necrosis factor antagonists. J Pediatr. 2008;153(3):432–4.Google Scholar
  80. 80.
    Buonuomo PS, Bracaglia C, Campana A, Insalaco A, Pardeo M, Cortis E, et al. Infliximab therapy in pediatric Takayasu’s arteritis: report of two cases. Rheumatol Int. 2011;31(1):93–5.Google Scholar
  81. 81.
    Stern S, Clemente G, Reiff A, Ramos MPR, Marzan KA, Terreri MT. Treatment of pediatric Takayasu arteritis with infliximab and cyclophosphamide: experience from an American–Brazilian cohort study. J Clin Rheumatol Pract Rep Rheum Musculoskelet Dis. 2014;20(4):183–8.Google Scholar
  82. 82.
    Malcić I, Detoni P, Kniewald H, Bartonicek D, Dilber D, Dietrich D, et al. Takayasu arteritis and possible cardiology repercussions in the childhood. Reumatizam. 2015;62(2):22–6.Google Scholar
  83. 83.
    Seyahi E, Ugurlu S, Cumali R, Balci H, Seyahi N, Yurdakul S, et al. Atherosclerosis in Takayasu arteritis. Ann Rheum Dis. 2006;65(9):1202–7.Google Scholar
  84. 84.
    Wang X, Dang A, Lv N, Cheng N, Cheng X. Inflammation Is associated with platelet coagulation function rather than enzymatic coagulation function in patients with Takayasu arteritis. Int Heart J. 2017;58(4):589–92.Google Scholar
  85. 85.
    Jordan NP, Bezanahary H, D’Cruz DP. Increased risk of vascular complications in Takayasu’s arteritis patients with positive lupus anticoagulant. Scand J Rheumatol. 2015;44(3):211–4.Google Scholar
  86. 86.
    De Souza AWS, De Lima CS, Oliveira ACD, Machado LSG, Pinheiro FAG, Hix S, et al. Homocysteine levels in Takayasu arteritis—a risk factor for arterial ischemic events. J Rheumatol. 2013;40(3):303–8.Google Scholar
  87. 87.
    De Souza AWS, Machado NP, Pereira VM, Arraes AED, Reis Neto ET, Mariz HA, et al. Antiplatelet therapy for the prevention of arterial ischemic events in Takayasu arteritis. Circ J Off J Jpn Circ Soc. 2010;74(6):1236–41.Google Scholar
  88. 88.
    Ueno M. Antiplatelet therapy in the treatment of Takayasu arteritis. Circ J Off J Jpn Circ Soc. 2010;74(6):1079–80.Google Scholar
  89. 89.
    Keser G, Direskeneli H, Aksu K. Management of Takayasu arteritis: a systematic review. Rheumatol Oxf Engl. 2014;53(5):793–801.Google Scholar
  90. 90.
    Perera AH, Youngstein T, Gibbs RGJ, Jackson JE, Wolfe JH, Mason JC. Optimizing the outcome of vascular intervention for Takayasu arteritis. Br J Surg. 2014;101(2):43–50.Google Scholar
  91. 91.
    Weyand CM, Goronzy JJ. Immune mechanisms in medium and large-vessel vasculitis. Nat Rev Rheumatol. 2013;9(12):731–40.Google Scholar
  92. 92.
    Wen Z, Shen Y, Berry G, Shahram F, Li Y, Watanabe R, et al. The microvascular niche instructs T cells in large vessel vasculitis via the VEGF-Jagged1-Notch pathway. Sci Transl Med. 2017;9(399):3322.Google Scholar
  93. 93.
    Piggott K, Deng J, Warrington K, Younge B, Kubo JT, Desai M, et al. Blocking the NOTCH pathway inhibits vascular inflammation in large-vessel vasculitis. Circulation. 2011;123(3):309–18.Google Scholar
  94. 94.
    Kötter I, Daikeler T, Amberger C, Tyndall A, Kanz L. Autologous stem cell transplantation of treatment-resistant systemic vasculitis–a single center experience and review of the literature. Clin Nephrol. 2005;64(6):485–9.Google Scholar
  95. 95.
    Kong X, Sun Y, Ma L, Chen H, Wei L, Wu W, et al. The critical role of IL-6 in the pathogenesis of Takayasu arteritis. Clin Exp Rheumatol. 2016;34(3 Suppl 97):S21–7.Google Scholar
  96. 96.
    Comparison of Mycophenolate Mofetil and Cyclophosphamide for Active Takayasu’s Arteritis—Full Text View—ClinicalTrials.gov [Internet]. https://clinicaltrials.gov/ct2/show/NCT03096275. Accessed 22 Dec 2018.

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ruchika Goel
    • 1
  • T. Sathish Kumar
    • 2
  • Debashish Danda
    • 1
    Email author
  1. 1.Department of Clinical Immunology and RheumatologyChristian Medical CollegeVelloreIndia
  2. 2.Department of Child HealthChristian Medical CollegeVelloreIndia

Personalised recommendations