Prolonged corticosteroid treatment in the management of temporal arteritis

Twenty-four patients with biopsy proven temporal arteritis were followed for 7 years and the effect and duration of corticosteroid treatment was evaluated. An initial dose of 35 mg prednisone daily was sufficient to control symptoms and signs in most of the patients. Flare-up rates upon corticosteroid reduction were high, especially in the first 24 months of treatment. Flare-ups were more common (greater than twice) in "non-western" Jews as compared to "western" Jews. Serious corticosteroid side effects were uncommon. Corticosteroid treatment was withdrawn from 7 patients after 5 years; two of these patients suffered flare-ups within 16 months. Nineteen patients remained on prednisone, in an average dose of 4 mg/day, 7 years after diagnosis. Thus, corticosteroid treatment in temporal arteritis should be prolonged in the majority of patients.