Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\26090367
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 World+J+Clin+Cases
2015 ; 3
(6
): 484-94
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Giant cell arteritis: Current treatment and management
#MMPMID26090367
Ponte C
; Rodrigues AF
; O'Neill L
; Luqmani RA
World J Clin Cases
2015[Jun]; 3
(6
): 484-94
PMID26090367
show ga
Glucocorticoids remain the cornerstone of medical therapy in giant cell arteritis
(GCA) and should be started immediately to prevent severe consequences of the
disease, such as blindness. However, glucocorticoid therapy leads to significant
toxicity in over 80% of the patients. Various steroid-sparing agents have been
tried, but robust scientific evidence of their efficacy and safety is still
lacking. Tocilizumab, a monoclonal IL-6 receptor blocker, has shown promising
results in a number of case series and is now being tested in a multi-centre
randomized controlled trial. Other targeted treatments, such as the use of
abatacept, are also now under investigation in GCA. The need for surgical
treatment is rare and should ideally be performed in a quiescent phase of the
disease. Not all patients follow the same course, but there are no valid
biomarkers to assess therapy response. Monitoring of disease progress still
relies on assessing clinical features and measuring inflammatory markers
(C-reactive protein and erythrocyte sedimentation rate). Imaging techniques
(e.g., ultrasound) are clearly important screening tools for aortic aneurysms and
assessing patients with large-vessel involvement, but may also have an important
role as biomarkers of disease activity over time or in response to therapy.
Although GCA is the most common form of primary vasculitis, the optimal
strategies for treatment and monitoring remain uncertain.