THU0319 TAKAYASU’S ARTERITIS: BEYOND THE VESSELS

Background Takayasu arteritis (TAK) is an inflammatory disease which primarily affects large vessels1. However, as a systemic disease, the spectrum of its manifestations is not limited to the arterial wall2. Objectives To describe characteristics of extravascular manifestations of TAK patients from a single Italian Centre. Methods Data records of TAK patients diagnosed according to the 1990 ACR criteria and followed-up at our Large Vessel Vasculitis Clinic were reviewed. Any significant inflammatory/autoimmune comorbidity and family history for inflammatory/autoimmune diseases were considered. For each comorbidity, temporal correlation with TAK diagnosis was assessed. Need for biological therapy for TAK control, as an indirect measure of TAK aggressiveness, was evaluated. Non-parametric statistic tests were used. Results In our cohort of 129 TAK patients, 46 patients (35.7%) were identified as having an inflammatory/autoimmune comorbidity, for a total of 64 comorbidities (14 patients experienced >1 comorbidity). Comorbidities were classified into 6 categories: systemic inflammatory diseases (17.2%); gastro-intestinal (9.4%), articular (10.9%), ocular (20.3%) and muco-cutaneous (39.1%) involvement; miscellaneous (autoimmune hepatitis (1.6%), retroperitoneal fibrosis (1.6%)). In 33 cases (51.6%) the comorbidity onset preceded, in 25 (39%) followed and in 6 (9.4%) was synchronous with TAK diagnosis (Table 1). In 25 patients (54.3%) use of a biological therapy to control TAK activity was needed (versus 35.4% in patients without comorbidities, p=0.042). Having a comorbidity increased the risk for the introduction of a biologic therapy, odds ratio=2.176 (1.042-4.541). Of the 129 TAK patients, 17 (13.2%) had a positive family history for inflammatory/autoimmune diseases (8 psoriasis, 5 rheumatoid arthritis, 3 inflammatory bowel disease, 1 sarcoidosis). Conclusion In TAK patients, extravascular involvement is a common finding and usually precedes the vascular involvement (the only significant exception is represented by inflammatory arthritis). Inflammatory and autoimmune extravascular comorbidities seem to be associated with a significant higher burden of vascular inflammation, as inferred by the higher rate of biological therapies use in these TAK patients. References [1] Numano, et al. Takayasu arteritis. Lancet (2000). [2] Kwon, et al. Extravascular manifestations of Takayasu arteritis: focusing on the features shared with spondyloarthritis. Arthritis Res Ther (2018) Disclosure of Interests Alessandro Tomelleri: None declared, Corrado Campochiaro Consultant for: Dr Corrado Campochiaro received consultation honoraria from Pfizer., Silvia Sartorelli: None declared, Veronica Bandini: None declared, 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.