Giant cell arteritis: beyond temporal artery biopsy and steroids
Jem V Ninan1,2, Susan Lester1,3, Catherine L Hill1,3,4
1Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
Internal Medicine Journal
|May 10, 2017
Summary
Giant cell arteritis (GCA) diagnosis is challenging. Imaging aids diagnosis, while interleukin-6 blockade shows promise for effective, less toxic GCA treatments.
Area of Science:
- Rheumatology
- Internal Medicine
- Vascular Medicine
Background:
- Giant cell arteritis (GCA) is the most common vasculitis in the elderly.
- Untreated GCA can lead to severe complications like vision loss and stroke.
- Diagnosis is complicated by the variable sensitivity of the temporal artery biopsy.
Purpose of the Study:
- To review the evolving role of imaging in diagnosing GCA.
- To discuss current and novel therapeutic strategies for GCA.
- To highlight the need for less toxic treatment alternatives.
Main Methods:
- Review of current literature on GCA diagnosis and treatment.
- Discussion of imaging modalities for GCA detection.
- Analysis of conventional and novel immunosuppressive agents, including biologics.
Main Results:
- Imaging is increasingly important for GCA diagnosis.
- Glucocorticoids remain standard but have significant side effects.
- Interleukin-6 blockade has shown recent therapeutic benefits.
Conclusions:
- Advanced imaging improves GCA diagnosis accuracy.
- Novel therapies, particularly IL-6 blockade, offer promising alternatives to long-term steroid use.
- Further research into targeted immunosuppression is crucial for managing GCA effectively.
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