Takayasu arteritis (TAK) is a chronic large-vessel vasculitis requiring prompt, evidence-based treatment to achieve remission and prevent irreversible vascular damage.

Treatment Goals

The aim of therapy is sustained remission: complete resolution of all active disease signs and symptoms, normalisation of inflammatory markers (ESR and CRP), and no evidence of progressive vessel narrowing or dilatation — maintained for at least 6 months.

Treatment Approach

First-line management of active TAK combines high-dose glucocorticoid therapy for remission induction with a conventional synthetic immunosuppressive agent — the specific drug selection, sequencing, and structured tapering schedule are detailed in the full protocol.

References

DOI: 10.1136/annrheumdis-2019-215672

High dose glucocorticoid (GC) therapy should be initiated immediately for induction of remission in active GCA or TAK.
Non-biologic disease modifying agents should be given in combination with GC in all patients with TAK.
The treatment target is sustained remission (absence of clinical signs and symptoms of active Tak associated with normal acute phase reactants) plus ability to taper GCs to the specified target without relapse.
Absence of all clinical signs and symptoms attributable to active LVV and normalisation of ESR and CRP; in addition, for patients with extracranial disease there should be no evidence of progressive vessel narrowing or dilatation (frequency of repeat imaging to be decided on an individual basis).

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What Is the First-Line Treatment of Takayasu Arteritis?