Rheumatology clinic

Old disease, new tricks. Update on giant cell arteritis

ABHISHIKTA DEY, ANTHONY M. SAMMEL

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© Oleg/stock.adobe.com model used for illustrative purposes only
© Oleg/stock.adobe.com model used for illustrative purposes only

Abstract

Early recognition of suspected giant cell arteritis (GCA) is paramount to prevent permanent visual loss. Recent developments such as increasing use of vascular imaging in diagnosis and the addition of tocilizumab to the treatment armamentarium have enhanced management. Patients with GCA generally have a good prognosis once they have been established on treatment.

Article Extract

Giant cell arteritis (GCA), also known as temporal arteritis, is a systemic medium to large vessel vasculitis that affects older people. It can cause acute irreversible visual loss, aortic aneurysm, posterior circulation strokes and peripheral artery stenosis. Rapid, accurate diagnosis is necessary to prevent sequelae. Recent advances include new vascular imaging and treatment options. Although temporal artery biopsy remains the gold standard diagnostic test, specialised noninvasive imaging modalities including positron emission tomography (PET)/CT and vascular ultrasound are increasingly being used in the diagnostic pathway. A new trial-proven corticosteroid-sparing treatment option, tocilizumab (monoclonal antibody to interleukin 6 [IL-6]), will increasingly become used in routine care.

Figures

© Oleg/stock.adobe.com model used for illustrative purposes only
© Oleg/stock.adobe.com model used for illustrative purposes only