Serious infections up risk of death in Takayasu arteritis

Patients with Takayasu arteritis (TA) who develop serious infections are susceptible to increased mortality, reveals a recent study.

Nearly one in five patients with TA (38/238, 16 percent) developed serious infections (50 episodes, multiple episodes in eight, with three resulting in death), of which the most common were pneumonia (n=19) and tuberculosis (n=12). Among the 38 initial episodes, 11 occurred in patients taking corticosteroids and 14 in those not on disease-modifying antirheumatic drug (DMARDs).

Patients with TA who developed serious infections, compared with those who did not, exhibited higher disease activity at presentation (active disease: 97.4 percent vs 69.5 percent; mean Indian Takayasu Arteritis Activity Score 2010: 12.7 vs 10.2; mean Disease Extent Index in Takayasu Arteritis: 11.2 vs 8.8). They were also more frequently initiated on corticosteroids or DMARDs.

Notably, mortality was significantly increased in patients with TA who developed a serious infection (hazard ratio [HR], 5.52, 95 percent confidence interval, 1.75–17.39).

This study identified serious infections, defined as infections resulting in hospitalization or death or unusual infections like tuberculosis, from a cohort of patients with TA. Researchers noted the use of DMARD and corticosteroids at the time of serious infections.

Comparisons were made on demographics characteristics, clinical presentation, angiography, disease activity at presentation, and DMARD use during follow-up between patients with TA with or without serious infections. The research team also compared mortality between the two groups using HRs.