2022 American College of Rheumatology/EULAR Classification Criteria for Takayasu Arteritis

Peter C. Grayson, Cristina Ponte, Ravi Suppiah, Joanna C. Robson, Katherine Bates Gribbons, Andrew Judge, Anthea Craven, Sara Khalid, Andrew Hutchings, Debashish Danda, Raashid A. Luqmani, Richard A. Watts, Peter A. Merkel, DCVAS Study Group

Research output: Contribution to journalArticlepeer-review


Objective: To develop and validate new classification criteria for Takayasu arteritis (TAK). Methods: Patients with vasculitis or comparator diseases were recruited into an international cohort. The study proceeded in 6 phases: 1) identification of candidate criteria items, 2) collection of candidate items present at diagnosis, 3) expert panel review of cases, 4) data-driven reduction of candidate items, 5) derivation of a points-based classification score in a development data set, and 6) validation in an independent data set. Results: The development data set consisted of 316 cases of TAK and 323 comparators. The validation data set consisted of an additional 146 cases of TAK and 127 comparators. Age ≤60 years at diagnosis and imaging evidence of large-vessel vasculitis were absolute requirements to classify a patient as having TAK. The final criteria items and weights were as follows: female sex (+1), angina (+2), limb claudication (+2), arterial bruit (+2), reduced upper extremity pulse (+2), reduced pulse or tenderness of a carotid artery (+2), blood pressure difference between arms of ≥20 mm Hg (+1), number of affected arterial territories (+1 to +3), paired artery involvement (+1), and abdominal aorta plus renal or mesenteric involvement (+3). A patient could be classified as having TAK with a cumulative score of ≥5 points. When these criteria were tested in the validation data set, the model area under the curve was 0.97 (95% confidence interval [95% CI] 0.94–0.99) with a sensitivity of 93.8% (95% CI 88.6–97.1%) and specificity of 99.2% (95% CI 96.7–100.0%). Conclusion: The 2022 American College of Rheumatology/EULAR classification criteria for TAK are now validated for use in research.

Original languageEnglish
Pages (from-to)1872-1880
Number of pages9
JournalArthritis & Rheumatology
Issue number12
Early online date8 Nov 2022
Publication statusPublished - Dec 2022

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