Serious Infections in Takayasu arteritis Save

The large vessel vasculitis, Takayasu arteritis (TAK), carries a significant morbid risk and a cohort analysis shows these patients are also at high risk of serious infection with resultant higher risk of death.

A cohort analysis of 238 TAK patients examined their demographics, presentations, angiography results, disease activity and treatments (steroids and DMARDs) and compared those with or without serious infections. Serious infections were defined as infections resulting in hospitalization or death or opportunistic infections like tuberculosis. 

Nearly 16% (n=38) of the 238 TAK patients developed serious infections (multiple episodes in 8, three deaths). Among the 38 initial episodes, less than one-third were untreated (11/38 not on corticosteroids and 14/38 not on DMARDs). 

The most commone infections were pneumonia (n=19) and tuberculosis (n=12). 

Higher levels of disease activity at presentation were seen in those TAK patients who experienced serious infections. 

An increased mortality rate was seen TAK patients with serious infections (HR 5.52, 95%CI 1.75-17.39).

Serious infections in TAK were related to disease activity and were seen in those on or off (~1/5) immunosuppression, but was nonetheless associated with increased mortality.