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Correspondence response
Response to eLetter: ‘Infections in giant cell arteritis and therapeutic implications’ by Moiseev et al
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  1. Rennie L Rhee1,
  2. Peter C Grayson2,
  3. Peter A Merkel1,
  4. Gunnar Tomasson3
  1. 1 Department of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
  2. 2 National Institutes of Health/NIAMS, Bethesda, Maryland, USA
  3. 3 University of Iceland, Reykjavik, Iceland
  1. Correspondence to Dr Rennie L Rhee, Department of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA; rennie.rhee{at}uphs.upenn.edu

https://doi.org/10.1136/annrheumdis-2016-210976

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    We thank Professor Moiseev and colleagues for showing their interest in our work.1 ,2 While we agree that our study does not completely refute the link between varicella zoster virus (VZV) and giant cell arteritis (GCA), we feel that stronger evidence of a link between VZV and GCA are needed before clinical trials are conducted in which patients with GCA are given antiviral therapy. If VZV, whether clinically overt, subclinical or latent, triggers the onset of GCA, we would have expected a stronger association between herpes zoster and GCA compared with the association of other infections with GCA. Although outside the scope of our study, we agree that the risk of infection following the institution of immunosuppressive therapy, including biological agents, for GCA is extremely important and needs to be further defined.

    References

    1. ↵
      2. Rhee RL ,
      3. Grayson PC ,
      4. Merkel PA , et al
      . Infections and the risk of incident giant cell arteritis: a population-based, case-control study. Ann Rheum Dis 2016; Published Online First 28 November 2016.
    2. ↵
      2. Moiseev S ,
      3. Novikov P ,
      4. Smitienko I , et al
      . Giant cell arteritis, infections and biologics. Ann Rheum Dis 2016; Published Online First 5 January 2017.
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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.

    Linked Articles

    • Correspondence
      Giant cell arteritis, infections and biologics
      Sergey Moiseev Pavel Novikov Ilya Smitienko Elena Shchegoleva
      Annals of the Rheumatic Diseases 2017; 76 e29-e29 Published Online First: 05 Jan 2017. doi: 10.1136/annrheumdis-2016-210955