Management overview for Takayasu arteritis

For a management approach common to most of the systemic vasculitides, including the principles of inducing and maintaining remission of disease, see Management overview for systemic vasculitides.

Takayasu arteritis requires specialist management and is treated with long-term, high-dose systemic corticosteroids.

The risk of patients developing life-threatening events is high due to the large vessels involved in Takayasu arteritis. Urgent specialist referral and early intensive induction therapy is usually required. Rheumatologists strongly encourage direct contact by general practitioners to expedite referral or obtain advice on treatment (eg before starting high-dose systemic corticosteroids).

Note: If Takayasu arteritis is suspected, urgent specialist referral and early high-dose systemic corticosteroid therapy is usually required.

Concurrent treatment of hypertension in Takayasu arteritis is important; see Hypertension and blood pressure reduction. It is unclear if antiplatelet drugs such as aspirin are beneficialMaz, 2021.

In the longer term, vascular surgery may be required for irreversible obstructive lesions. When possible, it is preferable to delay surgery until active inflammation is controlledMaz, 2021.