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Takayasu arteritis (AT) is a chronic granulomatous systemic vasculitis that affects large vessels and requires a multidisciplinary approach as the clinical signs are non-specific and disease activity is difficult to assess. Early rational drug treatment of AT suppresses both vascular and systemic inflammation, with glucocorticoids and immunosuppressants being of paramount importance. Advances in the understanding of the pathophysiology of AT have contributed to the development of new treatments that target key pro-inflammatory factors and involve the use of biologic disease-modifying antirheumatic drugs.

Large vessel vasculitis (LVV), including Takayasu's arteritis (AT, or non-specific aortoarteritis) and giant cell arteritis (GCA), is caused by granulomatous inflammation affecting mainly the aorta and its main branches. Damage to the vascular wall leads to ischemia of the corresponding organs and can be complicated by loss of vision, cerebral insufficiency and other life-threatening phenomena. The early diagnosis of these diseases in clinical practice is a difficult task that can only be solved by comparing the clinical symptoms, the results of the physical, laboratory and instrumental examination and the vascular biopsy.A comparative analysis of the 2018 and 2023 EULAR recommendations for imaging in LVV is presented. Duplex ultrasound (USDS) of not only temporal but also axillary arteries is recommended for GCA and magnetic resonance imaging (MRI) for AT. Alternative methods for GCA are MRI or positron emission tomography (PET) in combination with computed tomography (CT) and intravenous administration of fluorodeoxyglucose labelled with the short-lived fluoride isotope 18 (FDG-PET/CT), and for AT – FDG-PET/CT, CT or ultrasound examination. MRI, CT or ultrasound can be used for long-term monitoring of structural damage, especially to assess pre-existing vascular inflammation.

Damage to the cardiovascular system (CVS) in Takayasu arteritis (AT) is characterized by a wide range of clinical manifestations and an unfavorable prognosis of the disease. Objectives: determine the characteristics of clinical manifestations of damage to the CVS and predictors of unfavorable prognosis in Kyrgyz patients with АТ. Methods: The study included 135 patients with a reliable diagnosis of AT, verified according to the classification criteria of the American College of Rheumatology/The European Alliance of Rheumatology Associations (ACR/EULAR, American College of Rheumatology/European Alliance of Associations for Rheumatology). All patients underwent clinical and standard laboratory and instrumental examination. Results: CVC lesion was observed in 84.4% of patients with AT and was manifested mainly by secondary arterial hypertension (AH) and aortic regurgitation (AR) – 52.8% and 27.8% of cases, respectively. The main cause of secondary hypertension was renovascular hypertension (63.4%). Myocarditis (8.5%) and coronary syndrome (3.8%) were significantly less frequently diagnosed. Among the cardiovascular complications (CVc) that developed in 32.5% of patients, decompensated chronic heart failure (DCHF) (48.7%) and acute cerebrovascular accident (ACVA) were the most common (40,5%). The immediate cause of death in the observed cohort was DCHF (66.7%) due to severe AR (83.3%) and ischemic cardiomyopathy (16.7%). Predictors of the development of CVc were the V anatomical type of vascular lesion, high activity of the pathological process, severity of stenotic changes, serious clinical complications (CC) and severe AR (p

Lack of highly sensitive and specific methods of laboratory and instrumental diagnostics leads to difficulties in timely verification of Takayasu's arteritis (AT).Objective: to analyze the clinical course, laboratory and instrumental markers of vascular inflammation in the Kyrgyz cohort of patients with AT.Patients and methods. The study included 75 patients with a reliable diagnosis of AT, who were hospitalized and observed on an outpatient basis at the clinic of the National Center for Cardiology and Therapy named after acad. Mirsaida Mirrakhimova from January 2011 to April 2022. Patients were examined using clinical, laboratory and instrumental methods once every 2 years. The follow-up period was 1–5 years in 45 (60%) patients and 6–15 years in the remaining 30 (40%) patients. All patients underwent a clinical and standard laboratory work-up with CRP and interleukin 6 levels assessment, as well as ultrasound Dopplerography of peripheral arteries in the color Doppler mapping mode and multislice computed tomography-panaortography.Results and discussion. Lesions of the common carotid (85.33%) and subclavian (84%) arteries were detected more often. Involvement of the abdominal aorta was noted in 60% of patients and was accompanied by stenosis of the renal arteries in 100% of cases. The clinical picture of the disease was mainly represented by cardiac pathology in the form of arterial hypertension (84%) and aortic regurgitation (68%) with the development of decompensated chronic heart failure in 15% of patients. During the dynamic observation, significant improvement in the course of the disease, clinical symptoms, decrease in the severity of vascular changes were not revealed, with the exception of a decrease in the clinical activity of AT (p

Study of the interleukin 6 (IL-6) role in chronic autoimmune inflammation has led to the development of innovative treatments for various autoimmune inflammatory rheumatic diseases, including Takayasu’s arteritis (TAK). Given the important role of IL-6 in the pathogenesis of TAK and its association with high clinical and laboratory activity of the disease, tocilizumab (TCZ) is recommended as a second-line drug if both glucocorticoids and basic antiinflammatory drugs are inefficient, and previous therapy with tumor necrosis factor-α (alpha) inhibitors. The article presents our own observation of the successful use of TCZ in a patient with refractory TAK.