Arthritis and Takayasu's Arteritis
How Is Takayasu's Arteritis Treated? continued...
As the dosage of prednisone is gradually reduced, about half of all patients will have recurrent symptoms or progression of illness. This has led researchers to explore additional treatments to produce remission. Among medications that have been tried, with varying degrees of success, are immunosuppressive drugs such as methotrexate.
When these drugs are added to prednisone to treat Takayasu's arteritis, 50% of patients who had previously relapsed will achieve remission and be able to gradually discontinue prednisone. Overall, about 25% of patients will have disease that is not entirely controlled without continued use of these treatments. This emphasizes the need for continuing research to identify better and less toxic treatments for Takayasu's arteritis and other forms of vasculitis.
Many patients with Takayasu's arteritis have high blood pressure. Careful control of blood pressure is very important. Inadequate treatment of high blood pressure may result in stroke, heart disease, or kidney failure. In some cases, it is desirable to stretch narrow vessel openings with a balloon (a technique known as "angioplasty") or to do a bypass operation to restore normal flow to the kidney. This may result in normal blood pressure without the need to use blood pressure drugs.
Some patients may have serious disabilities because of narrowed blood vessels that supply other sites, such as the arms or legs. Bypass operations may correct these abnormalities. Aneurysms also can be surgically repaired.
What Is the Outlook For People With Takayasu's Arteritis?
In the U.S. and Japan, Takayasu's arteritis is fatal in only about 3% of patients who have had the disease for an average of five years. This encouraging statistic is the product of recognizing the disease and treating it appropriately. Reports from other parts of the world have been less optimistic, possibly because it is not as readily recognized and treated.
Will People With Takayasu's Arteritis Be Able to Live Normal Lives?
Approximately 25% of patients with Takayasu's arteritis seen at The Cleveland Clinic have an entirely normal lifestyle. Another 25% have had to make some adjustments in their activities. About half have had to modify their jobs and a small number of that group became occupationally disabled.
Takayasu's arteritis is clearly a treatable disease and most patients improve. However, it is apparent that many patients have to deal with consequences of this illness that may be partially or, less often, completely disabling. Close follow-up is required as drugs used to treat the disease have side effects that should be regularly monitored by a doctor.