Ab1328 Is There a Need for Routine Imaging Follow-Up in Patients With Takayasu Arteritis?

Background: Understanding disease progression in patients with Takayasu arteritis (TA) has not always been simple for rheumatologists due to possibility of mild vascular inflammation without clinical signs and ongoing vascular fibrosis independent of disease activity. There is no hesitation regarding the indication of radiological imaging in case of differences in clinical or laboratory findings however there is no consensus among rheumatologists on whether imaging should be performed at regular intervals to detect disease progression Objectives: It was aimed to determine the effectiveness of follow-up imaging in making treatment decisions. Methods: A total of 60 adult patients with TA whose followed up in eleven tertiary centers in Türkiye were included in this study. The clinical and laboratory findings as well as all imaging findings were recorded retrospectively from the outpatient clinic files. At each imaging visit, disease activity status and whether treatment changes were recorded. Results: The median age of the patients analyzed was 41 (20-68) years and 46 (77%) were women. Progression or activity was detected in 31 (20%) of a total of 153 images [15 (25%) for computerized tomography angiography, 2 (12%) positron emission tomography, 8 (24%) magnetic resonance angiography and 5 (13%) Doppler ultrasonography] were performed during a median follow-up period of 43 (14-142) months. In the progressive group, clinical activity rates and treatment change rates were found to be significantly higher compared with the non-progressive group (Table 1). On the other hand, physician global evaluation was active in 35 (28%) patients from non-progressive group and treatment changes were made in 30% of patients. Conclusion: In our study, no radiological progression or activity was detected in a significant portion of the patients who underwent radiological imaging. Treatment change rates are similar to physician global activity rates. It is understood that rheumatologists make treatment changes based on their clinical assessment rather than imaging findings. In this case, routine imaging follow-up in TA may not be appropriate, considering the cost and radiation exposure. Data collection continues and more definitive results will be obtained. REFERENCES: [1] Alibaz-Oner F, Direskeneli H. Update on Takayasu's arteritis. Presse Med. 2015 Jun;44(6 Pt 2):e259-65. DOI: 10.1016/j.lpm.2015.01.015. [2] Keser G, Aksu K, Direskeneli H. Takayasu arteritis: an update. Turk J Med Sci. 2018 Aug 16;48(4):681-697. DOI: 10.3906/sag-1804-136. Acknowledgements: NIL. Disclosure of Interests: None declared.