一项大型多中心队列研究：定期无创影像学随访对高须动脉炎的预后意义及合理性

IF 4.4 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2025-08-12 DOI:10.1016/j.semarthrit.2025.152813

Fatih Yıldırım , Fatih Tastekin , Safiye Bakkal , Muhammet Emin Kutu , Tuğba Ocak , Senar San , Aysegul Avcu , Hasan Kocaayan , Sema Işık , Burcu Ceren Uludogan , Gökçe Kenar Artın , Yavuz Pehlivan , Ediz Dalkilic , Nazife Sule Yasar Bilge , Fatma Alibaz-Oner , Ahmet Omma , Ayten Yazici , Ayse Cefle , Servet Akar , Cemal Bes , Nilüfer Alpay Kanıtez

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引用次数: 0

摘要

目的探讨定期影像学随访对高须动脉炎（Takayasu arteritis， TAK）预后的意义，并评价其合理性。方法回顾性多中心队列研究。来自11个三级中心的204名成年TAK患者，580名患者的影像学检查包括所有同期临床和实验室结果。结果中位随访时间为72（36-96）个月。580例显像中116例（20%）观察到放射活动和/或进展。在580例影像学检查中，有418例（72%）是在医生的整体评估（PGA）无效的情况下进行的。仅18例（4%）PGA无活性显像观察到放射活性和/或进展。低龄[OR 0.980；95% CI: 0.961 ~ 0.999, P = 0.041]和活性PGA [OR 31.766；95% CI: 17.961-56.219, P <； 0.001]是放射性活动和/或进展的预测因子。在疾病结局（MACE、VDI评分和死亡率）方面，接受定期影像学随访的患者与其他患者之间没有差异，而不考虑每年一次或更多次的临床活动。结论在缺乏临床活动的情况下，常规随访期间，TAK患者的放射活动和/或进展率很低。制定个性化的影像学随访计划似乎更合理，该计划将临床活动发现考虑在内，而不是常规的影像学随访。

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查看原文本刊更多论文

Prognostic significance and rationality of regular non-invasive imaging follow-up in Takayasu arteritis: A large multicenter cohort study

Objectives

To investigate the prognostic significance of regular imaging follow-up in Takayasu arteritis (TAK) and assess its rationality.

Methods

This was a retrospective multicenter cohort study. A total of 204 adult patients with TAK from 11 tertiary centers, and 580 imaging studies of these patients were included to encompass all concurrent clinical and laboratory findings.

Results

The median follow-up time was 72 (36-96) months. Radiological activity and/or progression was observed in 116 (20 %) of the 580 imaging. A total of 418 (72 %) of the 580 imaging were performed while the physician’s global assessment (PGA) was inactive. Radiological activity and/or progression was observed in only 18 (4 %) of the PGA inactive imaging. Younger age [OR 0.980; 95 % CI: 0.961-0.999, P = 0.041] and active PGA [OR 31.766; 95 % CI: 17.961-56.219, P < 0.001] were predictors of radiological activity and/or progression. There was no difference in terms of disease outcomes (MACE, VDI score, and mortality) between patients who underwent regular imaging follow-up regardless of clinical activity once a year or more and others.

Conclusion

In the absence of clinical activity, the rate of radiological activity and/or progression is very low in patients with TAK during routine follow-up. It seems more reasonable to develop a personalised imaging follow-up plan that takes clinical activity findings into account rather than regular imaging follow-up.

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.