Giant cell arteritis and polymyalgia rheumatica: current challenges and opportunities

Area of Science:

• Rheumatology and Immunology
• Vascular Inflammation
• Autoimmune Diseases

Background:

• Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are inflammatory conditions affecting large blood vessels.
• Recent advancements have improved understanding, early diagnosis, and treatment strategies for GCA and PMR.
• Preventing irreversible sight loss through prompt GCA diagnosis and treatment is a critical clinical goal.

Purpose of the Study:

• To discuss recent developments in the understanding of GCA and PMR.
• To highlight unmet needs in the epidemiology, pathogenesis, imaging, and treatment of these diseases.
• To explore the implications of new diagnostic and therapeutic approaches.

Main Methods:

• Review of recent clinical practice advancements in GCA and PMR.
• Inclusion of novel imaging techniques like ultrasonography in routine care.
• Evaluation of biologic agents, specifically IL-6 antagonists (e.g., tocilizumab), for treatment efficacy.

Main Results:

• Improved awareness and fast-track strategies aid early diagnosis, preventing sight loss in GCA.
• Ultrasonography and other imaging modalities are now standard in clinical practice.
• Biologic agents, particularly IL-6 inhibitors, show promise in treating GCA and PMR.

Conclusions:

• Recent progress has enhanced GCA and PMR management, improving patient outcomes.
• Key research questions remain regarding pathogenesis, the role of imaging, and optimal use of biologics.
• Addressing these unmet needs is crucial for advancing the care of patients with GCA and PMR.