Giant Cell Arteritis – Beyond temporal artery biopsy and steroids

Abstract
Giant cell arteritis is the commonest primary vasculitis of the elderly. The acute complications of untreated Giant cell arteritis such as vision loss or occasionally stroke can be devastating. The diagnosis is however not altogether straightforward due to variable sensitivities of the temporal artery biopsy as a reference diagnostic test. In this review, we discuss the increasing role of imaging in the diagnosis of Giant cell arteritis. Glucocorticoid treatment is the backbone of therapy but it is associated with significant adverse effects. A less toxic alternative is required. Conventional and novel immunosuppressive agents have only demonstrated modest effects in a subgroup of steroid refractory Giant cell arteritis due to the different arms of the immune system at play. However, recently a study of IL‐6 blockade demonstrated benefit in GCA. The current status of these immunosuppressive agents and novel therapies are also discussed in this review.

Source: Internal Medicine Journal - May 9, 2017 Category: Internal Medicine Authors: Jem V Ninan, Susan Lester, Catherine L Hill Tags: Review Source Type: research