AB0621 GENDER DIFFERENCES IN CLINICAL PRESENTATION AND VASCULAR PATTERN IN PATIENTS WITH TAKAYASU ARTERITIS
Authors: Alessandro Tomelleri, Corrado Campochiaro, Silvia Sartorelli, Giulio Cavalli, Giacomo De Luca, Elena Baldissera, Lorenzo Dagna
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Takayasu arteritis (TAK) is a chronic large-vessel vasculitis that predominantly affects aorta and its major branches. Although it is more commonly observed in asian population, it can occur worldwide. TAK affects more frequently women in their second and third decades of life, but occurrence in patients older than 40 years is not rare<sup>1</sup>. Female to male ratio is commonly reported as 9:1<sup>2</sup>. <h3>Objectives</h3> To compare clinical characteristics and pattern of vascular involvement at disease onset according to gender specificity in patients affected by TAK. <h3>Methods</h3> Data from 117 TAK patients (11 male, 106 female) diagnosed according to the aCR criteria from our Centre were retrospectively collected. Differences between men and women with regard to demographic features, diagnostic delay, signs and symptoms attributed to TAK, and arteries involved at diagnosis were compared. Data from 3 published articles describing sex differences in TAK patients were obtained<sup>3,4,5</sup>. A global analysis of these 3 cohorts plus ours (for a total of 578 patients, 108 men and 470 women) was performed. <h3>Results</h3> In our TAK cohort, age at disease onset and age at diagnosis were not significantly different between men and women. Diagnostic delay was slightly higher in men. Male patients showed higher involvement of iliac arteries (right, p=0.016; left, p=0.021); female patients suffered more frequently from upper limbs claudication (p=0.026). In the overall analysis, men had higher prevalence of arterial hypertension (p=0.007) and more frequent involvement of abdominal aorta (p=0.026), renal arteries (right, p&lt;0.001; left, p&lt;0.001) and iliac arteries (right, p=0.009; left, p=0.002). Women more frequently exhibited upper limb claudication (p=0.042) and involvement of left subclavian artery (p=0.005), carotid arteries (right, p&lt;0.001; left, p&lt;0.001) and supradiaphragmatic aorta (ascending, p=0.050; arch, p&lt;0.001; descending, p=0.003). Inflammatory markers were more frequently raised in women (p=0.005). <h3>Conclusion</h3> In TAK patients, gender has a strong influence on pattern of vascular involvement and consequently on clinical presentation. Specifically, women have higher involvement of the supradiaphragmatic vessels, whereas in men the abdominal vessels are more frequently affected. <h3>References</h3> [1] Numano, et al. Takayasu arteritis. Lancet (2000). [2] Fatos, et al. Epidemiology of Takayasu arteritis. Presse Med (2017) [3] Lim aY, et al. Gender differences in clinical and angiographic findings of patients with Takayasu arteritis. Clin Exp Rheumatol (2015) [4] Sharma BK, et al. A possible role of sex in determining distribution of lesions in Takayasu arteritis. Int J Cardiol (1998) [5] Mont'Alverne aR de S, et al. Features of the onset of Takayasu's arteritis according to gender. Arq Bras Cardiol (2013) <h3>Disclosure of interests</h3> Alessandro Tomelleri: None declared, Corrado Campochiaro Consultant for: Dr Corrado Campochiaro received consultation honoraria from Pfizer., Silvia Sartorelli: None declared, Giulio Cavalli Consultant for: Dr Giulio Cavalli received consultation honoraria from Pfizer, Novartis and SOBI., Giacomo De Luca Speakers bureau: Pfeizer, Sobi, Elena Baldissera Consultant for: Consultation honoraria from Novartis and Rottapharm, Speakers bureau: Pfeizer, Sobi, Novartis, Lorenzo Dagna Consultant for: Prof Lorenzo Dagna received consultation honoraria from abbvie, amgen, Biogen, Bristol-Myers Squibb, Celltrion, Novartis, Pfizer, Sanofi-Genzyme, and SOBI.