Reviewing the Pathophysiology Behind the Advances in the Management of Giant Cell Arteritis

Improving understanding of the underlying pathophysiology of giant cell arteritis (GCA) is transforming clinical management by identifying novel avenues for targeted therapies. One key area of concern for both clinicians and patients with GCA is glucocorticoid (GC) morbidity. The first randomised co...

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Bibliographic Details
Published in:Ophthalmology and therapy 2019-06, Vol.8 (2), p.177-193
Main Authors: Al-Mousawi, Alia Z., Gurney, Sam P., Lorenzi, Alice R., Pohl, Ute, Dayan, Margaret, Mollan, Susan P.
Format: Article
Language:English
Subjects:
Anterior ischaemic optic neuropathy
Autoimmune diseases
Cytokines
Eye diseases
Giant cell arteritis
Glucocorticoid toxicity
Immunosuppressive agents
Interleukin-6
Internal Medicine
Large vessel vasculitis
Medicine
Medicine & Public Health
Monoclonal antibodies
Ophthalmology
Review
Side-effects
Vein & artery diseases
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Summary:Improving understanding of the underlying pathophysiology of giant cell arteritis (GCA) is transforming clinical management by identifying novel avenues for targeted therapies. One key area of concern for both clinicians and patients with GCA is glucocorticoid (GC) morbidity. The first randomised controlled trials of targeted treatment to reduce cumulative GC use in GCA have been published, with tocilizumab, an interleukin (IL)-6 receptor inhibitor, now the first ever licensed treatment for GCA. Further potential therapies are emerging owing to our enhanced understanding of the pathophysiology of the disease. Other improvements in the care of our patients are rapid access pathways and imaging techniques, such as ultrasound, which are becoming part of modern rheumatology practice in the UK, Europe and beyond. These have been highlighted in the literature to reduce delay in diagnosis and improve long-term outcomes for those investigated for GCA.
ISSN:2193-8245
2193-6528
DOI:10.1007/s40123-019-0171-0