Background/Purpose: The management of Takayasu’s arteritis (TAK) is challenging for lack of largescale, high-quality clinical trials. Cyclophosphamide (CYC) is a conventional rst-line immunosuppressant but is associated with reproductive toxicity and increased risk of malignancy. This study evaluated the ecacy and safety of mycophenolate mofetil (MMF) combined with methotrexate (MTX) compared to CYC followed by azathioprine (AZA) in treating active TAK. Methods: Patients aged 18 or older with active TAK were randomized 2:1 to receive MMF+MTX or CYC/AZA. All subjects received high-dose glucocorticoids (GCs) with a predened tapering plan. MMF was dosed at 750mg or 1000mg twice daily based on body weight (< 50kg or ≥50kg), and MTX was given at 15mg weekly. CYC was administered intravenously at 15mg/kg for 10 infusions over 28 weeks, followed by oral AZA at 100mg daily. Patients were followed for 52 weeks to evaluate treatment ecacy and safety. The primary endpoint was the overall response rate at 52 weeks. Secondary endpoints included complete and partial response rates at 28 and 52 weeks. Complete response was dened as the resolution of active disease signs, normalization of ESR and CRP, no progression on imaging, and GCs dose < 15mg daily of prednisone or equivalent.