Large-vessel giant cell arteritis: Diagnosis, monitoring and management

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22 Citations (Scopus)

Abstract

GCA is a chronic, idiopathic, granulomatous vasculitis of medium and large arteries. It comprises overlapping phenotypes including classic cranial arteritis and extra-cranial GCA, otherwise termed large-vessel GCA (LV-GCA). Vascular complications associated with LV-GCA may be due, in part, to delayed diagnosis, highlighting the importance of early identification and prompt initiation of effective therapy. Advancements in imaging techniques, including magnetic resonance angiography, CT angiography, PET and colour duplex ultrasonography, have led to improvements in the diagnosis of LV-GCA; however, the role imaging modalities play in the assessment of disease activity and long-term outcomes remains unclear. Glucocorticoids are the mainstay of therapy in LV-GCA, but their prolonged use is associated with multiple, sometimes serious, adverse effects. Recent data suggest that biologic therapies, such as tocilizumab, may be effective and safe steroid-sparing options for patients with GCA. However, data specifically evaluating the management of LV-GCA are limited.

Original languageEnglish (US)
Pages (from-to)ii32-ii42
JournalRheumatology (United Kingdom)
Volume57
DOIs
StatePublished - Feb 1 2018

Fingerprint

Giant Cell Arteritis
Biological Therapy
Magnetic Resonance Angiography
Delayed Diagnosis
Vasculitis
Glucocorticoids
Blood Vessels
Ultrasonography
Arteries
Color
Steroids
Phenotype
Therapeutics
Computed Tomography Angiography
tocilizumab

Keywords

  • Biologic therapy
  • Diagnosis
  • Giant cell arteritis
  • Glucocorticoids
  • Imaging
  • Prognosis
  • Tocilizumab
  • Vasculitis

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)

Cite this

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title = "Large-vessel giant cell arteritis: Diagnosis, monitoring and management",
abstract = "GCA is a chronic, idiopathic, granulomatous vasculitis of medium and large arteries. It comprises overlapping phenotypes including classic cranial arteritis and extra-cranial GCA, otherwise termed large-vessel GCA (LV-GCA). Vascular complications associated with LV-GCA may be due, in part, to delayed diagnosis, highlighting the importance of early identification and prompt initiation of effective therapy. Advancements in imaging techniques, including magnetic resonance angiography, CT angiography, PET and colour duplex ultrasonography, have led to improvements in the diagnosis of LV-GCA; however, the role imaging modalities play in the assessment of disease activity and long-term outcomes remains unclear. Glucocorticoids are the mainstay of therapy in LV-GCA, but their prolonged use is associated with multiple, sometimes serious, adverse effects. Recent data suggest that biologic therapies, such as tocilizumab, may be effective and safe steroid-sparing options for patients with GCA. However, data specifically evaluating the management of LV-GCA are limited.",
keywords = "Biologic therapy, Diagnosis, Giant cell arteritis, Glucocorticoids, Imaging, Prognosis, Tocilizumab, Vasculitis",
author = "Matthew Koster and Matteson, {Eric Lawrence} and Warrington, {Kenneth J}",
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T1 - Large-vessel giant cell arteritis

T2 - Diagnosis, monitoring and management

AU - Koster, Matthew

AU - Matteson, Eric Lawrence

AU - Warrington, Kenneth J

PY - 2018/2/1

Y1 - 2018/2/1

N2 - GCA is a chronic, idiopathic, granulomatous vasculitis of medium and large arteries. It comprises overlapping phenotypes including classic cranial arteritis and extra-cranial GCA, otherwise termed large-vessel GCA (LV-GCA). Vascular complications associated with LV-GCA may be due, in part, to delayed diagnosis, highlighting the importance of early identification and prompt initiation of effective therapy. Advancements in imaging techniques, including magnetic resonance angiography, CT angiography, PET and colour duplex ultrasonography, have led to improvements in the diagnosis of LV-GCA; however, the role imaging modalities play in the assessment of disease activity and long-term outcomes remains unclear. Glucocorticoids are the mainstay of therapy in LV-GCA, but their prolonged use is associated with multiple, sometimes serious, adverse effects. Recent data suggest that biologic therapies, such as tocilizumab, may be effective and safe steroid-sparing options for patients with GCA. However, data specifically evaluating the management of LV-GCA are limited.

AB - GCA is a chronic, idiopathic, granulomatous vasculitis of medium and large arteries. It comprises overlapping phenotypes including classic cranial arteritis and extra-cranial GCA, otherwise termed large-vessel GCA (LV-GCA). Vascular complications associated with LV-GCA may be due, in part, to delayed diagnosis, highlighting the importance of early identification and prompt initiation of effective therapy. Advancements in imaging techniques, including magnetic resonance angiography, CT angiography, PET and colour duplex ultrasonography, have led to improvements in the diagnosis of LV-GCA; however, the role imaging modalities play in the assessment of disease activity and long-term outcomes remains unclear. Glucocorticoids are the mainstay of therapy in LV-GCA, but their prolonged use is associated with multiple, sometimes serious, adverse effects. Recent data suggest that biologic therapies, such as tocilizumab, may be effective and safe steroid-sparing options for patients with GCA. However, data specifically evaluating the management of LV-GCA are limited.

KW - Biologic therapy

KW - Diagnosis

KW - Giant cell arteritis

KW - Glucocorticoids

KW - Imaging

KW - Prognosis

KW - Tocilizumab

KW - Vasculitis

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