Treatment Protocol

 

There is currently no one superior agent used to treat childhood TA. However, individual centres have provided treatment protocols with a high success rate.

In one study[1], 6 patients between the ages of 12 to 17 years were treated using the following:

1.       If the disease was on only one side of the diaphragm with no pulmonary disease Oral steroids and oral MTX (12.5mg/m2/week)
2.       If the disease was more widespread Oral steroids and oral CYC (1.5-1.7 mg/kg/day) for a total of 12 weeks (max total dose of 150mg/kg) followed by oral MTX as above (12.5mg/m2/week) for 12 to 18 months
3.       Life threatening disease Pulse methylprednisolone given for 3 consecutive days
4.       In patients whose APRs were normal Oral prednisone started at 1 mg/kg/day for 4 weeks tapered to a maintenance dosage of 5 to 10 mg/day by 12 weeks.

In the last visit of this study, 5 patients were all found to be symptom-free. During the course of this study, one patient died and one patient had a relapse stenosis of the graft after one year (though found symptom-free later).  All patients were still on low-dose alternate-day corticosteroids as of June 1, 2006.

 

Figure 3: Flowchart outlining the treatment protocol of Takayasu arteritis


Hunter GG. Treatment of Takayasu arteritis. UpToDate: http://www.uptodate.com/contents/treatment-of-takayasu-arteritis?source=see_link. Accessed July 7, 2016.

Forsey J, Dhandayuthapani G, Hamilton MCK, Martin RP, Tizard EJ, Ramanan AV. Takayasu arteritis: key clinical factors for early diagnosis. Arch Dis Child, 2011. 96(5): p. 176-82.

Ozen S, Duzova A, Bakkaloglu A, Bilginer Y, Cil BE, Demircin M, Davin JC, Bakkalog M. Takayasu Arteritis in Children: Preliminary Experience with Cyclophosphamide Induction and Corticosteroids Followed by Methotrexate. J Pediatr, 2007. 150(1): p. 72-6.

Source: Ashish JM, Ruchika G, Sathish K, Debashish D. Childhood-onset Takayasu arteritis: an update. Int J Rheum Dis, 2016. 19(2): p. 116-26.