POS0073 EXTRA-VASCULAR MANIFESTATIONS OF TAKAYASU ARTERITIS
Authors: R. Padoan, A. Tomelleri, C. Kavadichanda, A. Jose, K. Singh, U. Rathore, L. Iorio, F. Davanzo, M. Codirenzi, E. Rinaldi, E. Baldissera, V. Agarwal, L. Dagna, C. Campochiaro, A. Doria, D. P. Misra
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Takayasu arteritis (TAK) is a systemic disease characterized by large vessel involvement. Although the vascular characteristics of TAK are well characterized, there is currently a lack of organized research examining the non-vascular manifestations of the disease. <h3>Objectives:</h3> The objective was to assess extra-vascular manifestations in a large cohort of TAK patients. <h3>Methods:</h3> Patients diagnosed with TAK from 4 independent cohorts in tertiary referral centres (2 from Italy and 2 from India) were included. Characteristics were retrospectively collected from an electronic dataset. Logistic regression analysis was performed to evaluate the association between vascular and extravascular manifestations. Variables determined statistically significant (p&lt;0.05) at univariate analysis were included in a multivariate analysis. <h3>Results:</h3> We included 407 patients (163 Italy; 244 India), 79.1% female, with a median follow-up of 80±123 months. Mean age at diagnosis was 32±13, with a diagnostic delay of 20±50 months. Mean baseline Disease Extent Index for TAK (DEI.Tak) and Indian TAK Clinical Activity (ITAS2010) scores were 8.8 ± 5.5 and 10.4 ± 6.6, respectively. Italian patients presented more frequently fatigue (p&lt;0.001), arthralgia (p&lt;0.001), carotidynia (p&lt;0.001), acute coronary syndrome (p=0.017), but less vertigo (p=0.020), stroke (p=0.005), seizure (p=0.032), pulse loss (p=0.002), arterial hypertension (p&lt;0.001), acute kidney injury (p=0.003) and heart failure (p=0.002). Only 0.7% were asymptomatic at diagnosis. At least one TAK extravascular manifestation was observed in 11.3% of patients (23.3% Italy vs 3.3% India, p&lt;0.001), with the most common being erythema nodosum (4.2%), followed by inflammatory bowel diseases (4.1%), uveitis/scleritis (3.7%) arthritis/sacroiliitis (3.2%), oral ulcers (2.1%), peripheral neuropathy (1.4%). 7 (1.7%) patients had 2 concomitant extravascular manifestations, while 4 (1.0%) had 3, and only 1 (0.2%) had 4. Italian patients presented more frequently erythema nodosum (p&lt;0.001) and uveitis/scleritis (p=0.013). Patients with extravascular manifestations were older (p=0.005), with a longer diagnostic delay (p=0.030). No differences were noted in acute phase reactants. On univariate analysis, syncope, retinopathy, and acute coronary syndrome were significantly associated with extravascular involvement (p=0.039, p=0.021, and p=0.018, respectively), while arterial hypertension and heart failure were inversely associated (p&lt;0.001, p=0.023, respectively). On multivariate analysis, retinopathy (p=0.033) and acute coronary syndrome (p=0.046) remained significant. 348 (85.5%) cases received glucocorticoids, 331 (81.3%) conventional immunosuppressants, and 115 (28%) biologics. Those with extra-vascular involvement were treated more frequently with biologics (p&lt;0.001). Vascular procedures were performed in 101 patients (24.8%), with no differences between groups. <h3>Conclusion:</h3> Extravascular manifestations of TAK are not rare, with a prevalence of 11.3% of patients, and erythema nodosum is the most common extravascular manifestation. Patients with extra-vascular manifestations are older and experience a longer diagnostic delay, significantly associated with the presence of retinopathy and acute coronary syndrome. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>