Hi, Takayasu’s arteritis is progressive, and there is no definitive therapy. Glucocorticoids and immunosuppressive agents are effective in some patients during the acute phase but have the risk of side effects as you have experienced with prednisolone... Surgical bypass or endovascular intervention of a critically stenotic artery may be necessary. What you are having is some large artery occlusion in the upper limb, causing ischemic/claudication pain on active movement of the limb. Angiography is needed to delineate focal or segmental changes/occlusion in large arteries in the upper extremities. Synthetic or autogenous bypass grafts need to be placed onto disease-free segments of vessels. For focal lesions, there have been reports of success with angioplasty and may provide relief. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist