Published in:
01-12-2020 | Giant Cell Arteritis | Recent Advances in Large Vessel Vasculitis ( C Dejaco and C Duftner, Section Editors)
Treatment of Giant Cell Arteritis and Takayasu Arteritis—Current and Future
Authors:
B. Hellmich, A. F. Águeda, S. Monti, R. Luqmani
Published in:
Current Rheumatology Reports
|
Issue 12/2020
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Abstract
Purpose of Review
Guidelines for the management of large vessel vasculitides have been recently updated by several scientific societies. We have evaluated the current recommendations for treatment of giant cell arteritis (GCA) and Takayasu arteritis (TA) and addressed potential future therapeutic strategies.
Recent Findings
While glucocorticoids (GCs) remain the gold standard for induction of remission, many patients relapse and acquire high cumulative GC exposure. Thus, GC-sparing therapies such as methotrexate are recommended for selected patients with GCA and all patients with TA. Recent high-quality evidence shows that tocilizumab is an effective GC-sparing agent in GCA. Non-biologic and biologic immunomodulators also appear to have GC-sparing properties in TA.
Summary
Tocilizumab is now considered to be part of the standard treatment for GCA, particularly with relapsing disease, but questions on its use such as length of treatment and monitoring of disease activity remain open. High-quality evidence to guide treatment of TA is still lacking.