Takayasu's arteritis medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Most people with Takayasu’s arteritis respond to [[steroids]] such as [[prednisone]]. The usual starting dose is approximately 1 milligram per kilogram of body weight per day (for most people, this is approximately 60 milligrams a day). The two most important aspects of treatment: are controlling the inflammatory process and controlling [[hypertension]]. | |||
==Medical Therapy== | ==Medical Therapy== | ||
Medical therapy of Takayasu arteritis depends on the disease activity and the complications that develop.<ref name="pmid12655">{{cite journal |vauthors=Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE |title=Takayasu's arteritis. Clinical study of 107 cases |journal=Am. Heart J. |volume=93 |issue=1 |pages=94–103 |date=January 1977 |pmid=12655 |doi= |url=}}</ref> | Medical therapy of Takayasu arteritis depends on the disease activity and the complications that develop.<ref name="pmid12655">{{cite journal |vauthors=Lupi-Herrera E, Sánchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE |title=Takayasu's arteritis. Clinical study of 107 cases |journal=Am. Heart J. |volume=93 |issue=1 |pages=94–103 |date=January 1977 |pmid=12655 |doi= |url=}}</ref> | ||
Revision as of 21:33, 13 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]
Overview
Most people with Takayasu’s arteritis respond to steroids such as prednisone. The usual starting dose is approximately 1 milligram per kilogram of body weight per day (for most people, this is approximately 60 milligrams a day). The two most important aspects of treatment: are controlling the inflammatory process and controlling hypertension.
Medical Therapy
Medical therapy of Takayasu arteritis depends on the disease activity and the complications that develop.[1]
The two most important aspects of treatment:
- Controlling the inflammatory process
- Controlling hypertension
Corticosteroids
- Corticosteroids are the mainstay of therapy for active Takayasu arteritis
- Most people with Takayasu’s arteritis respond to steroids such as prednisone
- The usual starting dose is approximately 1 milligram per kilogram of body weight per day
- Long-term, low-dose corticosteroid therapy may be required
- Osteoporosis prevention when patients are started on corticosteroids should be considered
IL-6 receptor inhibitor
- Humanized monoclonal antibody tocilizumab suggested as a treatment for Takayasu arteritis through blockade of the soluble interleukin-6 (IL-6) receptor.
B-cell depletion
- B cells are believed to have an antibody-independent effect, which may modulate regulatory T-cell immune reactions against foreign and self-antigens.
- Rituximab is an example of B-cell depletion that has been shown to improve clinical signs and symptoms of Takayasu arteritis.
Cytotoxic agents
- Methotrexate, azathioprine, and cyclophosphamide are
- Used for patients whose disease is steroid resistant or relapsing
- Continued for at least 1 year after remission and are then tapered to discontinuation