Giant Cell Arteritis: 2018 Review
1Anne Winkler, MD, PhD, MACP, FACR, MSMA member since 2003, on the Editorial Board for Rheumatology for Missouri Medicine. She is on the clinical faculty of Missouri State University in Southwest Missouri and has been principal investigator in multiple clinical trials.
Missouri Medicine
|November 3, 2018
Insights
Giant cell arteritis (GCA) is a common large vessel vasculitis. Tocilizumab effectively reduces GCA relapses and lowers the required steroid dosage, improving patient outcomes.
Area of Science:
- Rheumatology
- Immunology
- Vasculitis Research
Background:
- Giant cell arteritis (GCA) is the most prevalent form of large vessel vasculitis.
- GCA classically presents with headaches, scalp tenderness, visual disturbances, and polymyalgic symptoms.
- Current primary treatment involves high-dose corticosteroids, often necessitating steroid-sparing agents.
Purpose of the Study:
- To evaluate the efficacy of tocilizumab in managing giant cell arteritis.
- To assess tocilizumab's impact on relapse rates in GCA patients.
- To determine the effect of tocilizumab on cumulative corticosteroid dosage.
Main Methods:
- Clinical trials investigating tocilizumab for GCA.
- Analysis of relapse rates in patients treated with tocilizumab compared to standard care.
- Monitoring of cumulative steroid dose in patients receiving tocilizumab.
Main Results:
- Tocilizumab significantly reduced the relapse rate in patients with giant cell arteritis.
- Treatment with tocilizumab led to a lower cumulative corticosteroid dose.
- Methotrexate demonstrated some utility in reducing steroid dependence.
Conclusions:
- Tocilizumab is an effective therapy for giant cell arteritis, significantly lowering relapse rates.
- Tocilizumab facilitates a reduction in long-term corticosteroid exposure.
- Tocilizumab offers a valuable therapeutic option for managing GCA and mitigating steroid toxicity.
Abstract:
Giant cell arteritis is the most common large vessel vasculitis. Classic symptoms include headaches, scalp tenderness, visual loss and muscle stiffness and pain. First line treatment is with high dose steroids but methotrexate may be of some help in decreasing steroid use. Tocilizumab has been shown to significantly decrease relapse rate and lower steroid cumulative dose.
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