Indian Journal of Rheumatology

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 16  |  Issue : 4  |  Page : 375--380

Rate and predictors of response to glucocorticoid therapy in patients of takayasu arteritis at a tertiary level hospital of Bangladesh: A longitudinal study


Farzana Shumy1, Ahmad Mursel Anam2, Minhaj Rahim Choudhury3, Md Abu Shahin3, Syed Atiqul Haq3, Md Zahid Amin4, Sumayia Minhaj5 
1 Department of Rheumatology & Internal Medicine, Square Hospitals Ltd, Dhaka, Bangladesh
2 Department of Critical Care & Internal Medicine, Square Hospitals Ltd, Dhaka, Bangladesh
3 Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
4 Department of Medicine, Central Police Hospital, Dhaka, Bangladesh
5 Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Correspondence Address:
Dr. Farzana Shumy
Associate Consultant, Department of Rheumatology & Internal Medicine, Square Hospitals Ltd, Dhaka
Bangladesh

Objectives: This study aimed to assess the rate of inactive disease in Bangladeshi patients with Takayasu arteritis (TA) treated with prednisolone and to identify the characteristics in patients that may guide in choosing induction therapy. Methods: The longitudinal study enrolled active TA patients who received 1 mg/kg/day of prednisolone. Disease activity was assessed by Indian Takayasu Activity Score - C-Reactive Protein (ITAS-CRP) and ITAS2010 at baseline and after 1, 3, and 6 months. The patients who did not achieve inactive disease or again became active during tapering of prednisolone received methotrexate. Results: Among 12 active TA patients, one patient succumbed to death after 15 days. ITAS2010 1 month after steroid showed a significant difference between remission and nonremission patients (P 0.0001). However, five out of 11 (45.45%) patients became inactive. These five patients had onset of symptoms <15 months prior to the initiation of therapy and had no history of syncope, stroke, and complications such as aortic regurgitation and hypertension. Reappearance of a pulse was noted in three out of 11 patients. The presence of carotidynia (P = 0.03) was a significant predictor for the reappearance of pulse. After 6 months, one patient (9.1%) remained inactive with prednisolone alone and other subjects received methotrexate. Conclusion: The response to prednisolone is variable in TA. The presence of carotidynia was a predictor for the reappearance of pulse. Monotherapy with prednisolone is not a good choice as an induction therapy.


How to cite this article:
Shumy F, Anam AM, Choudhury MR, Shahin MA, Haq SA, Amin MZ, Minhaj S. Rate and predictors of response to glucocorticoid therapy in patients of takayasu arteritis at a tertiary level hospital of Bangladesh: A longitudinal study.Indian J Rheumatol 2021;16:375-380


How to cite this URL:
Shumy F, Anam AM, Choudhury MR, Shahin MA, Haq SA, Amin MZ, Minhaj S. Rate and predictors of response to glucocorticoid therapy in patients of takayasu arteritis at a tertiary level hospital of Bangladesh: A longitudinal study. Indian J Rheumatol [serial online] 2021 [cited 2022 Jan 19 ];16:375-380
Available from: https://www.indianjrheumatol.com/article.asp?issn=0973-3698;year=2021;volume=16;issue=4;spage=375;epage=380;aulast=Shumy;type=0