Monitoring Disease Activity in Patients With Takayasu Arteritis With the OMERACT Takayasu Ultrasound Score (OTUS) (MOTUS)
A Multicenter Prospective Observational Study on the Role of the OMERACT Takayasu Ultrasound Score (OTUS) in Monitoring Disease Activity in Patients With Takayasu Arteritis
연구 개요
상태
상태
정황
정황
상세 설명
연구 유형
연구 유형
등록 (추정된)
등록
참여기준
자격 기준
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
샘플링 방법
연구 인구
The study population will consist of patients with TAK and active disease, either newly diagnosed or experiencing a relapse. Active disease is defined as the presence of clinical signs and/or symptoms attributable to TAK, with or without elevation of inflammatory markers (ESR, CRP), and/or imaging evidence of active vasculitis (excluding US findings used in OTUS scoring).
Patients of any gender, aged ≥18 years, will be eligible.
설명
Inclusion Criteria:
- Age ≥18 years
- Male and female
- Diagnosis of TAK according to the 1990 ACR and/or 2022 ACR/EULAR classification criteria
Active disease, defined as the presence of at least two of the following three domains:
- Clinical domain: new onset or worsening of clinical signs and/or symptoms attributable to TAK;
- Laboratory domain: elevation of inflammatory markers, defined as ESR and/or CRP above the upper limit of normal according to local laboratory standards, not attributable to causes other than TAK;
- Imaging domain: imaging evidence of active vasculitis on modalities other than ultrasound, including FDG-PET, magnetic resonance angiography (MRA), or computed tomography angiography (CTA).
- Ability to undergo serial vascular ultrasound assessments during follow-up
- Provision of signed informed consent
Exclusion Criteria:
- Inability or contraindication to undergo vascular US
- Severe comorbidities limiting participation or follow-up
- Concomitant conditions that may confound ultrasound findings (e.g., significant atherosclerosis requiring intervention, complete occlusion of one of the arterial segments under investigation)
- Diagnosis of another rheumatologic disease
- Refusal or inability to provide informed consent
공부 계획
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디자인 세부사항
연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Change in OTUS between active disease and remission in patients with Takayasu arteritis
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24. For the primary endpoint only baseline → first remission visit will be analyzed.
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Change in OTUS from baseline (active disease) to the first visit at which clinical remission is achieved, as determined by the treating physician (blinded to ultrasound results).
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US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24. For the primary endpoint only baseline → first remission visit will be analyzed.
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2차 결과 측정
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
To evaluate the agreement between OTUS-based activity assessment and NIH disease activity score
기간: Baseline, month 1, month 3, month 6, month 12, month 18, month 24
|
Cohen's kappa coefficient measuring agreement between OTUS-based disease activity classification and the National Institutes of Health (NIH) disease activity score for Takayasu arteritis (range 0-4, with higher scores indicating more active disease).
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Baseline, month 1, month 3, month 6, month 12, month 18, month 24
|
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Hazard ratio for time to relapse per unit increase in baseline OTUS score
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Time to disease relapse (months), defined as recurrence of clinical signs and/or symptoms attributable to TAK with or without elevation of inflammatory markers, as judged by the treating physician.
The hazard ratio per unit increase in baseline OTUS score will be estimated using Cox proportional-hazards regression.
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US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
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Hazard ratio for time to vascular damage progression per unit increase in baseline OTUS score
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Time to vascular damage progression (months), defined as new or worsening stenosis, occlusion, or aneurysm detected on CTA, MRA, or vascular US compared to baseline.
The hazard ratio per unit increase in baseline OTUS score will be estimated using Cox proportional-hazards regression.
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US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
|
Odds ratio for successful glucocorticoid discontinuation per unit increase in baseline OTUS score
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Proportion of patients achieving successful glucocorticoid discontinuation, defined as complete GC tapering without relapse for at least 3 consecutive months.
The odds ratio per unit increase in baseline OTUS score will be estimated using logistic regression.
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US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Hazard ratio for time to relapse per unit increase in OTUS change from baseline to month 3
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Time to disease relapse (months), defined as recurrence of clinical signs and/or symptoms attributable to TAK with or without elevation of inflammatory markers, as judged by the treating physician.
The hazard ratio per unit increase in OTUS change from baseline to month 3 (ΔOTUS) will be estimated using Cox proportional-hazards regression.
|
US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
|
Hazard ratio for time to vascular damage progression per unit increase in OTUS change from baseline to month 3
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
Time to vascular damage progression (months), defined as new or worsening stenosis, occlusion, or aneurysm detected on CTA, MRA, or vascular US compared to baseline.
The hazard ratio per unit increase in OTUS change from baseline to month 3 (ΔOTUS) will be estimated using Cox proportional-hazards regression.
|
US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
|
Odds ratio for successful glucocorticoid discontinuation per unit increase in OTUS change from baseline to month 3
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
Proportion of patients achieving successful glucocorticoid discontinuation, defined as complete GC tapering without relapse for at least 3 consecutive months.
The odds ratio per unit increase in OTUS change from baseline to month 3 (ΔOTUS) will be estimated using logistic regression.
|
US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
|
To assess the diagnostic ability of OTUS to detect clinical relapse during follow-up.
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Diagnostic performance of OTUS for relapse detection
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US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Absolute OTUS score in treatment responders vs non-responders
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Absolute OTUS score at each visit compared between clinical responders and non-responders to treatment, defined by physician global assessment.
Difference between groups will be assessed using Mann-Whitney U test, with effect size estimation.
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US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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OTUS change from baseline (ΔOTUS) in treatment responders vs non-responders
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Change in OTUS score from baseline to each follow-up visit (ΔOTUS) compared between clinical responders and non-responders to treatment, defined by physician global assessment.
Difference between groups will be assessed using Mann-Whitney U test, with effect size estimation.
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US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
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Correlation between OTUS changes and clinical/laboratory markers of disease activity in Takayasu arteritis
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
Correlation between OTUS variation and: (i) ESR/CRP; (ii) clinical disease activity, as assessed by the Physician Global Assessment (PGA) of disease activity (0-10 visual analogue scale) and the National Institutes of Health (NIH) disease activity score for Takayasu arteritis.
|
US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
|
Agreement between OTUS-based disease activity classification and Physician Global Assessment (PGA) in Takayasu arteritis
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
Cohen's kappa coefficient measuring agreement between OTUS-based disease activity classification and Physician Global Assessment (PGA) of disease activity, assessed on a 0-10 visual analogue scale.
|
US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
기타 결과 측정
기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Reference values for arterial wall thickness measured by vascular ultrasound in assessed arterial segments
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Arterial wall thickness (mm) measured by standardized vascular ultrasound in the bilateral common carotid, subclavian and axillary arteries, and abdominal aorta.
Descriptive statistics will be used to define reference values and proposed normality cut-offs.
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US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
|
Change in OTUS score over time stratified by treatment class
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
Change in OTUS score (continuous, expressed as ΔOTUS from baseline) over 24 months, compared across therapeutic classes (e.g., glucocorticoids alone, conventional immunosuppressants, biologics).
Differences between treatment groups will be analyzed using linear mixed-effects models.
|
US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
|
Proportion of patients with changes in ultrasound lesion characteristics over time stratified by treatment class
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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Proportion of patients (%) showing new, resolved, or persistent elementary ultrasound lesions (macaroni sign, stenosis, occlusion) as defined by OMERACT criteria, compared across therapeutic classes.
Differences between treatment groups will be described using proportions and compared using chi-square or Fisher's exact test as appropriate.
|
US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
|
To compare OTUS findings with FDG-PET, MRA and/or CTA obtained as part of routine clinical practice.
기간: US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
|
Concordance between OTUS and PET/MRA/CTA findings, both qualitative and quantitative (when available).
|
US performed at baseline, month 1, month 3, month 6, month 12, month 18, month 24.
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기타 연구 ID 번호
기타 연구 ID 번호
- TAK-MOTUS
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