Barra L, et al. – This nationwide survey was planned to analyze the variations in the clinical practice of physicians managing Takayasu arteritis (TAK). Evidence reported that the physician practices for the management of TAK were variable. These findings indicated that there were knowledge gaps, which probably impact outcomes in patients with TAK.

Methods

• In 495 Canadian adult and pediatric rheumatologists an online survey (developed by the Canadian Vasculitis Network and approved by the Canadian Rheumatology Association) containing 48 questions with regard to the diagnosis, monitoring and treatment of TAK was distributed by email.

Results

• In total 66 rheumatologists completed the survey (13% response rate): the majority (73%) were from academic centers and ≤25% reported managing more than ten patients in their career.
• A combination of signs and symptoms of ischemia, elevations of inflammatory markers and vascular imaging (typically computed tomography and magnetic resonance angiography) were the basis of diagnosis of TAK.
• Findings revealed that the frequency of monitoring for disease activity and the methods employed (clinical, laboratory or imaging) were variable.
• All physicians used corticosteroids for the treatment of TAK, but 42% would treat for at least 6–12 months, 26% for 12–24 months and 23% would never stop corticosteroids.
• 53% would always use an immunosuppressant (most commonly methotrexate or azathioprine) in addition to corticosteroids and the remainder would only start an immunosuppressant in patients with refractory or relapsing disease.