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Takayasu arteriitis (TA) is een zeldzame chronische vasculitis met aantasting van voornamelijk de aorta en zijn hoofdtakken. TA komt vooral voor bij vrouwen tussen 10 en 40 jaar. De ziekte is meer prevalent is Aziatische landen maar is wereldwijd beschreven. In deze retrospectieve serie van 21 patiënten beschrijven we de presentatie, diagnose, beeldvorming met nieuwere technieken zoals PET-scan, behandeling en uitkomst in een Belgische Universitair Centrum. Onze bevindingen komen overeen met deze van andere series uit Noord-Amerika en Europa. Grotere prospectieve multicentrische studies zijn nodig om de verschillende diagnostische methoden te vergelijken en evalueren en op deze manier de diagnose en behandeling van TA te optimaliseren.

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Background Adult onset Still Disease (AOSD) is a rare systemic auto-inflammatory disease and potentially life-threatening illness. Over the past decades, several new therapeutical drugs have become available for treatment of AOSD. In this review, we assess the possible benefit of the implementation of a treat-to-target strategy on clinical outcome. Methods MEDLINE, EMBASE, Web of Science and the Cochrane database were searched for all original studies on patients with AOSD. We excluded case reports, case series, and reviews. Studies with data on a treat-to-target-related approach were included in the final analysis. Results Patients treated with high dose corticosteroids have a better response and more favorable prognosis compared to those treated with low dose corticosteroids. Rapid attainment of remission seems associated with a higher frequency of a monocyclic disease course, but we found no outcome benefit associated with early administration of anakinra. Several studies suggest that the choice of the biological disease-modifying antirheumatic drug (DMARD) should consider the predominant disease manifestations, advocating a personalized medicine approach. Conclusion With regards to a treat-to-target strategy, limited evidence suggests that early achievement of remission in patients with AOSD may result in a better prognosis. However, there are no strong data to support that the early administration of corticosteroid-sparing DMARDs and biological DMARDs is required to achieve this goal. Personalized medicine may play a key role in the future therapeutic approach of patients with AOSD.

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