Five clinical conundrums in the management of giant cell arteritis.
Clinicians who treat patients with giant cell arteritis (GCA) face many unresolved challenges. Visual loss still occurs in 15% to 20% of patients despite the availability of therapy for the disease that is generally effective. Aneurysm formation and large vessel stenosis are increasingly recognized complications. Substantial iatrogenic morbidity stems from glucocorticoid therapy, and recent trials have failed to identify an efficient steroid sparing agent. In this review, the authors address five major clinical conundrums in the management of GCA.
Cid
Maria C
MC
Vasculitis Research Unit, Department of Internal Medicine, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain. mccid@clinic.ub.es
García-Martínez
Ana
A
Lozano
Ester
E
Espígol-Frigolé
Georgina
G
Hernández-Rodríguez
José
J
D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D001011:Aorta / Q000473:pathology; D001027:Aortography; D001379:Azathioprine / Q000008:administration & dosage; D004108:Dilatation, Pathologic; D013700:Giant Cell Arteritis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008727:Methotrexate / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage; D020551:Pulse Therapy, Drug; D036542:Tomography, Spiral Computed; D014786:Vision Disorders / Q000209:etiology
D000020:Abortifacient Agents, Nonsteroidal; D005938:Glucocorticoids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001379:Azathioprine; D011241:Prednisone; D008727:Methotrexate