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How is Takayasu's disease treated?
Last reviewed: 04.07.2025
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Indications for hospitalization in Takayasu's disease
Indications for hospitalization: debut, exacerbation of the disease, examination to determine the treatment protocol in remission, need for surgical intervention.
Indications for consultation with other specialists
- Neurologist, ophthalmologist - high blood pressure, cerebrovascular syndrome.
- Phthisiatrician - tuberculosis infection in a patient with non-specific aortoarteritis.
- Surgeon - severe abdominal syndrome. Deciding on the need for surgical treatment.
- ENT, dentist - pathology of ENT organs, need for dental sanitation.
Non-drug treatment of Takayasu's disease
During the acute period of Takayasu's disease, hospitalization, bed rest, and diet No. 5 are mandatory.
Drug treatment of Takayasu's disease
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Pathogenetic treatment
In the acute phase, medium doses of prednisolone (1 mg/kg per day with a dose reduction after 1-2 months to a maintenance dose) and methotrexate (at least 10 mg/m2 once a week) are prescribed . The maximum dose of prednisolone is given until the disappearance of clinical and laboratory signs of process activity, after which it is slowly reduced to a maintenance dose (10-15 mg/day). In the chronic phase of nonspecific aortoarteritis, the patient receives maintenance doses of prednisolone and methotrexate (usually at the initial dose); if there is no process activity within 1-2 years, the therapy is discontinued.
Symptomatic treatment
According to indications, courses of treatment with drugs that improve collateral circulation (pentoxifylline, dipyridamole, etc.) are prescribed. Patients with arterial hypertension undergo hypotensive therapy. In the case of antiphospholipid syndrome in the acute phase, anticoagulants are prescribed with subsequent transition to warfarin or acetylsalicylic acid.
Surgical treatment of Takayasu's disease
According to indications (single saccular aortic aneurysm, aneurysm dissection, high blood pressure and unilateral renal artery stenosis), surgical intervention is performed: prosthetics, bypass, endarterectomy, etc.
Prognosis for Takayasu's disease
Most patients who have experienced the acute phase of nonspecific aortoarteritis or several exacerbations remain able to work for a long time.
The prognosis is generally favorable, the life expectancy of patients is decades. The prognosis is more serious in young children with widespread damage to the aorta and its branches and chronic recurrent course of the disease, with damage to the renal arteries and arterial hypertension. Mortality is minimal. The cause of death in severe cases of Takayasu's disease can be: circulatory failure, ruptured aortic aneurysm, cerebral hemorrhage, chronic renal failure.