[Giant cell arteritis after the age of 75].
Despite its increasing incidence giant cell arteritis is not well detected in the elderly. Response to corticosteroid treatment is the same before and after the age of 75, but there are many steroid-induced side effects, particularly bone fractures, in the elderly. Therefore, it is important to reduce the corticosteroid load in elderly and frail people. In this cases, 0.3 to 0.5mg/kg, or 15 to 25mg daily prednisone-equivalent dose at start seems to be enough to prevent blindness in simple forms. This dose has to be rapidly reduced whenever the C-reactive protein remains moderately elevated. Moreover, an anti-agregant or anticoagulant treatment must be associated at the beginning of steroid treatment to prevent ischemic complications, as well as biphosphonates, which could prevent corticosteroid-induced osteoporosis.
Chevalet
Pascal
P
Service de Médecine Polyvalente Gériatrique, Hôpital Bellier, 41, rue Curie, BP 84607, 44046 Nantes Cedex 1, France. pascal.chevalet@chu-nantes.fr
Masseau-Imbert
Agathe
A
Durand-Fix
Marie-Hélène
MH
Agard
Christian
C
Brisseau
Jean-Marie
JM
Rodat
Olivier
O
Barrier
Jacques-Henri
JH
D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use; D016903:Drug Monitoring; D005260:Female; D016330:Frail Elderly; D013700:Giant Cell Arteritis / Q000188:drug therapy*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced / Q000517:prevention & control; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D006493:Heparin; D011241:Prednisone