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Ustekinumab for the treatment of refractory giant cell arteritis
  1. Richard Conway1,2,
  2. Lorraine O'Neill1,
  3. Eileen O'Flynn1,
  4. Phil Gallagher1,
  5. Geraldine M McCarthy3,
  6. Conor C Murphy4,
  7. Douglas J Veale1,
  8. Ursula Fearon1,
  9. Eamonn S Molloy1
  1. 1Department of Rheumatology, Centre for Arthritis and Rheumatic Diseases, St Vincent's University Hospital, Dublin Academic Medical Centre, Dublin 4, Ireland
  2. 2CARD Newman Research Fellow, University College Dublin, Dublin 4, Ireland
  3. 3Mater Misericordiae University Hospital, Dublin Academic Medical Centre, Dublin 7, Ireland
  4. 4RCSI Department of Ophthalmology, Royal College of Surgeons of Ireland, Royal Victoria Eye and Ear Hospital, Dublin 2, Ireland
  1. Correspondence to Dr Richard Conway, Department of Rheumatology, Centre for Arthritis and Rheumatic Diseases, St Vincent's University Hospital, Dublin Academic Medical Centre, Elm Park, Dublin 4, D04 T6F4, Ireland; drrichardconway{at}gmail.com

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Giant cell arteritis (GCA) is the most common form of systemic vasculitis.1 Glucocorticoids are the mainstay of therapy, required in high doses for prolonged periods, with consequent serious complications in 86% of patients.2 There is a critical unmet need for a proven safe and effective immunosuppressive therapy in GCA, as agents such as methotrexate and infliximab have shown disappointing results in GCA.3 ,4 Interleukins 12 (IL-12) and 23 (IL-23) are implicated in Th1 and Th17 responses, respectively, both inflammatory pathways relevant to GCA pathogenesis.5 ,6 A recent case series reported the use of ustekinumab in three patients with Takayasu arteritis.7 The aim of this study was to evaluate the glucocorticoid-sparing efficacy of ustekinumab, an IL-12/IL-23-blocking monoclonal antibody, in patients with refractory GCA.

Patients with GCA attending our centre are enrolled in a prospective registry and managed according to standardised …

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