Giant cell arteritis: Update on clinical manifestations, diagnosis, and management

Area of Science:

• Rheumatology
• Internal Medicine
• Vascular Medicine

Background:

• Giant cell arteritis (GCA) is the most prevalent vasculitis in individuals over 50.
• Historically focused on cranial vessels, GCA is now recognized as a multifaceted syndrome involving cranial, extra-cranial arteries, and girdles.
• Heterogeneity in GCA presentation contributes to diagnostic delays and potential for acute/chronic damage.

Purpose of the Study:

• To review current diagnostic and therapeutic strategies for Giant cell arteritis.
• To highlight clinical updates and novelties in GCA management over the past decade.
• To address ongoing challenges in understanding GCA, such as histological correlations and long-term complication prevention.

Main Methods:

• Narrative review of recent literature on Giant cell arteritis.
• Focus on advancements in diagnostic tools and therapeutic interventions.
• Emphasis on clinical practice relevance and emerging trends.

Main Results:

• Vascular ultrasound has transformed GCA diagnosis, offering a rapid, non-invasive, and cost-effective approach.
• Tocilizumab is now a key therapeutic option, improving disease control, particularly in steroid-refractory cases.
• Significant progress has been made in understanding and managing GCA, though further research into histological patterns and vascular complication prevention is needed.

Conclusions:

• Giant cell arteritis is a complex vasculitic syndrome requiring a comprehensive diagnostic and therapeutic approach.
• Innovations in imaging and targeted therapies have significantly improved patient outcomes.
• Continued research is essential to fully elucidate GCA pathogenesis and optimize long-term management strategies.