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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
06:35

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

Published on: February 8, 2019

The treatment of giant cell arteritis

J Alexander Fraser1, Cornelia M Weyand, Nancy J Newman

  • 1Department of Clinical Neurological Sciences, University of Western Ontario School of Medicine, London, Ontario, Canada.

Reviews in Neurological Diseases
|October 8, 2008
PubMed

Insights

Giant cell arteritis (GCA) treatment requires individualized care, especially for neuro-ophthalmic and neurological complications. High-dose steroids and close monitoring are recommended for acute cases, while long-term steroid-sparing options need further study.

Area of Science:

  • Rheumatology
  • Neurology
  • Ophthalmology

Background:

  • Giant cell arteritis (GCA) is a vasculitis responsive to corticosteroids, but long-term management challenges persist.
  • GCA presents diverse clinical subtypes, necessitating tailored treatment strategies.
  • Existing literature shows varied recommendations for GCA management.

Purpose of the Study:

  • To systematically review treatment options for neuro-ophthalmic and neurological complications of GCA.
  • To evaluate evidence for adjuvant therapies in GCA management.
  • To provide recommendations for managing acute GCA complications.

Main Methods:

  • Systematic literature review of treatment options for GCA with ocular and neurological involvement.
  • Analysis of evidence for adjuvant therapies.
  • Formulation of clinical recommendations based on available data.

Main Results:

  • No randomized controlled trials specifically address GCA with ocular/neurological complications.
  • Hospital admission for high-dose intravenous methylprednisolone is recommended for acute visual loss or brain ischemia.
  • Aspirin may offer benefits; evidence for steroid-sparing agents like methotrexate is debated.

Conclusions:

  • Individualized treatment is crucial for GCA, particularly for severe complications.
  • Prompt, high-dose corticosteroid therapy and monitoring are vital for acute neuro-ophthalmic/neurological GCA.
  • Further research is needed to clarify the role of steroid-sparing agents in long-term GCA management.

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