Do we need treatment with tumour necrosis factor blockers for giant cell arteritis?
1 Unit of Rheumatology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy
2 Mayo Clinic College of Medicine, Rochester, Minnesota, USA
Correspondence to:
Dr Carlo Salvarani, Unit of Rheumatology, Arcispedale S. Maria Nuova, V. le Risorgimento N80, 42100 Reggio Emilia, Italy; salvarani.carlo@asmn.re.it
Accepted 28 January 2008
| The first 150 words of the full text of this article appear below. |
For many years glucocorticoids (GCs) have been known to effectively suppress the clinical manifestations of giant cell arteritis (GCA), and prevent its ischaemic complications. GCs are still the treatment of choice for this disease. It is recommended that GC therapy be commenced as soon as the diagnosis of GCA is established. An initial dose of 40–60 mg/daily of prednisone (or equivalent) as a single or divided dose is generally found to be adequate in the vast majority of the cases.1 2 Higher-dose pulse GC therapy has been advocated by some for patients with recent or pending visual disturbances, but an observational study and a randomised controlled trial (RCT) failed to demonstrate superiority of pulse over oral GC therapy in preventing ischaemic complications.3 4
The initial dose of GCs is usually given for 2 to 4 weeks until all reversible signs and symptoms have resolved and acute phase reactants are back to normal.
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Ann Rheum Dis 2008 67: 625-630.[Abstract] [Full Text] [PDF]
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