Turkish Society for Rheumatology (Turkish Takayasu Arteritis Study Group) recommendations for the diagnosis, follow-up and the treatment of Takayasu's arteritis

OBJECTIVES: To develop evidence-based and expert opinion guided recommendations for Takayasu's arteritis (TAK) management. METHODS: A systematic literature review was conducted following the principles outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. To structure the key clinical questions, the task force employed the Population, Intervention, Comparison, and Outcome (PICO) format. The European League Against Rheumatism (EULAR) standardised operating procedures was subsequently applied to grade the quality of the collected evidence and determine the strength of each recommendation. RESULTS: This guideline provides 40 recommendations under the headings: diagnosis, follow-up, medical treatment, pregnancy and surgical interventions. As randomised controlled trials are very limited in number without conclusive results, most data come from case series with low-level evidence. We recommend conventional immunosuppressives as the first choice during remission-induction. Tumour necrosis factor-inhibitors or tocilizumab can be considered in patients with relapsing or refractory disease despite conventional immunosuppressives. CONCLUSIONS: The first Turkish Takayasu Arteritis Study Group recommendations deriving from a current literature review and large clinical experience, aim to guide clinicians not only in Turkey, but also in other countries who are providing health care to patients with TAK.