[Large-vessel vasculitis-giant cell and Takayasu arteritis]

Area of Science:

• Rheumatology
• Immunology

Background:

• Large-vessel vasculitis encompasses giant cell arteritis (GCA) and Takayasu arteritis (TA).
• GCA typically affects individuals over 50, predominantly women, presenting with acute symptoms like headaches.
• TA usually manifests in younger populations with systemic inflammation affecting the aorta and its branches.

Purpose of the Study:

• To outline the diagnostic and therapeutic strategies for GCA and TA.
• To highlight recent advancements in treatment, including novel biologic agents.

Main Methods:

• Diagnosis of GCA relies on imaging, with histology as an optional confirmation.
• Treatment of GCA involves initial oral prednisone, with tocilizumab (TCZ) demonstrating high efficacy.
• TA management includes steroids, disease-modifying antirheumatic drugs, and biologics like infliximab or TCZ.

Main Results:

• Tocilizumab (TCZ) is highly effective for GCA treatment, offering an alternative to or adjunct with steroids.
• Methotrexate can be used as a steroid-sparing agent in GCA.
• TA treatment involves a combination of therapies, including TCZ and infliximab.

Conclusions:

• Prompt diagnosis and treatment are crucial for GCA to prevent complications like blindness.
• Both GCA and TA require tailored treatment approaches, with biologics like TCZ offering new therapeutic avenues.
• Understanding the distinct clinical presentations and treatment responses is key for managing these large-vessel vasculitides.