Indian Takayasu Clinical Activity Score (ITAS2010)

ITAS 2010 Calculator

Carotidynia

Limb Claudication

Bruits

Absent Pulse

Blood Pressure Inequality

Aortic Regurgitation

Myocardial Involvement

Pulmonary Involvement

Retinal Changes

CNS Symptoms

Renal Involvement

GI Involvement

ITAS 2010 Score: –

–

Differentiates between active and inactive disease in Takayasu arteritis (TAK).

Why Use

Can be used as a standardized clinical tool for quantifying TAK disease activity. More specific to TAK and easier to complete than the BVAS. Aids in treatment escalation decisions, particularly regarding glucocorticoids and immunosuppressive therapy.

When to Use

Use in patients with Takayasu arteritis (TAK) to assess disease activity and guide treatment decisions. Can be applied at initial diagnosis to establish baseline disease activity and at follow-up visits to monitor treatment response and detect relapses.

Formula

Addition of the selected points: Variable Points Systemic None 0 Malaise or weight loss >2 kg 1 Myalgia, arthralgia, or arthritis 1 Headache 1 Abdominal None 0 Severe abdominal pain (pain presenting as an emergency with features of bowel ischemia, best confirmed by imaging or surgery) 1 Genitourinary None 0 Recent history of spontaneous abortion (spontaneous fetal loss within 12 weeks) 1 Renal None 0 Systolic BP >140 1 Diastolic BP >90 2 Neurologic None 0 Stroke 2 Seizures (not hypertensive) 1 Syncope 1 Vertigo/dizziness 1 Cardiovascular None 0 Bruits 2 Pulse inequality 2 New loss of pulses 2 Claudication 2 Carotidynia 2 Aortic incompetence 1 Myocardial infarct/angina 1 Cardiomyopathy/cardiac failure 1 Carotid bruits Right 1 Left 1 Subclavian bruits Right 1 Left 1 Renal bruits Right 1 Left 1 Pulse and BP inequality Not present 0 Present 1 Carotid pulse loss Right 1 Left 1 Subclavian pulse loss Right 1 Left 1 Brachial pulse loss Right 1 Left 1 Radial pulse loss Right 1 Left 1 Femoral pulse loss Right 1 Left 1 Popliteal pulse loss Right 1 Left 1 Posterior tibial pulse loss Right 1 Left 1 Dorsalis pedis pulse loss Right 1 Left 1 Claudication Arm 1 Leg 1

Pearls / Pitfalls

Derived from the Disease Extent Index for TAK (DEI.Tak), which was adapted from the Birmingham Vasculitis Activity Score (BVAS). Developed using data from Indian patients and externally validated in Brazilian and Turkish populations; regional and ethnic differences may affect its validity and generalizability. Does not include acute phase reactants or imaging, which should also be considered when assessing disease activity; a variation of the tool (ITAS-A) is available that includes acute phase reactants. Studies indicate it may not fully distinguish between active disease and nonvasculitis-related damage. Rule out concurrent conditions (e.g., infection) before attributing new or worsening symptoms to TAK and adjusting therapy.

Management

The following cutoffs are based on the original study by Misra et al. (2013) : Inactive disease (score <2): Consider tapering immunosuppressive therapy cautiously. Active disease (score ≥2): Consider intensifying treatment with corticosteroids, additional immunosuppressants, and/or biologic therapy. Evaluate treatment adherence and exclude other conditions that may mimic disease activity. Persistent elevation despite treatment may warrant vascular imaging to assess progression and rule out complications.

Advice

This tool is not intended to replace good clinical judgment and specialist expertise. Use as part of a comprehensive evaluation (e.g., physical examination, laboratory data, imaging studies) to guide treatment decisions and monitoring.

More Information

Interpretation: ITAS2010 Score Disease Activity <2 Inactive ≥2 Active