01 - JANUARY - Vol. - 38, No. -1, 2020 (35) Summary: Takayasus arteritis (TA) is a rare, idiopathic, chronic inflammatory disease with cell-mediated inflammation, involving mainly the aorta and its major branches. It leads to stenosis, occlusion or aneurysmal degeneration of large arteries. The clinical presentation is characterized by an acute phase with constitutional symptoms, followed, months or years later, by a chronic phase in which symptoms relate to fibrosis or occlusion of vessels. Conventional angiography, the gold standard method for initial diagnosis, appears to have been replaced with new imaging modalities such as magnetic resonance angiography (MRA) and 18F- fluorodeoxyglucose positron emission tomography (FDG- PET) in recent years. These are also used for the assessment of disease activity. New tools for disease assessment such as Indian Takayasus Arteritis Score 2010 (ITAS2010) and color Doppler ultrasound (CDUS) aim to better characterize and quantify disease activity. Leflunomide, tumor necrosis factor (TNF)-– antagonists, and tocilizumab are new options for patients resistant to conventional therapies. Prognosis is possibly getting better, with lower mortality in recent years due to recent advancement in investigations and management. Key words: vasculitis, Takayasus arteritis, pulseless disease, disease assessment, outcome. (J Bangladesh Coll Phys Surg 2020; 38: 35-45) DOI: http://dx.doi.org/10.3329/jbcps.v38i1.44687 REVIEW ARTICLE Takayasus Arteritis- A Review AM AZIZ a , R YASMIN b , MA HAQUE c , D YEASMIN d a. Dr. Ahmad Monjurul Aziz, Junior Consultant, Department of Medicine, Dhaka Dental College Hospital Dhaka, Bangladesh. b. Dr. Rubina Yasmin Professor & Head Department of Medicine Dhaka Dental College Dhaka, Bangladesh. c. Dr. Md Azharul Haque Associate Professor Department of Medicine Dhaka Dental College Dhaka, Bangladesh. d. Dr. Dilruba Yeasmin, Junior Consultant Department of Gynae Oncology National Institute of Cancer Research and Hospital Mohakhali, Dhaka. Address of Correspondence: Dr. Ahmad Monjurul Aziz Junior Consultant Department of Medicine Dhaka Dental College Hospital Dhaka, Bangladesh Phone: +8801715040286 Email: amaemon@gmail.com Received: 15 May, 2018 Accepted: 10 Oct., 2019 Introduction Takayasu’s arteritis (TA) is a rare, chronic large-vessel arteritis that predominantly affects the aorta, its major branches, and the pulmonary arteries. Segmental stenosis, occlusion, dilatation, or aneurysm formation may occur in the vessel wall during the course of the disease. 1-4 All large arteries can be affected, although the ascending/descending aorta, subclavian arteries, and extra cranial arteries such as carotids are most frequently involved (60%–90%). The disease generally has a prolonged indolent course. Clinical feature varies from constitutional features (fever, malaise, anorexia, and weight loss) to visual loss or stroke. Absent or diminished pulses, bruits, and absent blood pressure can be present according to the vessel involved. 5 Given the rarity of TA, the search strategy needed to be comprehensive, allowing varied study designs (RCTs, and observational prospective and retrospective studies). By including high-quality evidence from RCTs, and potentially lower quality evidence from small observational studies such as cohorts or case series, we aimed to ensure that the results better reflect clinical practice. To maximise results, a wide and indepth search was conducted encompassing the Medline, Embase and Cochrane libraries. In this review, we will summarize the recent developments in the diagnosis, clinical course, disease assessment with biomarkers/imaging, outcomes, and new treatment options of TA. Epidemiology TA has world-wide distribution, but prevalent in Asian populations. 6,7 It was first reported in 1908 by Japanese ophthalmologists. 8,9 TA is seen predominantly in young women (female: male ration 8:1) with a typical onset at the age of 25-30 years. 10-11 A comparative study from France investigated TA among white, North African, and black patients. 12 The median age at diagnosis was 39.3 years in white, 28.4 years in North African, and 28.0