Recent Advances in Giant Cell Arteritis

Curr Rheumatol Rep. 2018 Apr 2;20(5):25. doi: 10.1007/s11926-018-0737-1.

Abstract

Purpose of review: Giant cell arteritis (GCA) is the most common systemic vasculitis. GCA is categorized as a granulomatous vasculitis of large and medium size vessels. Majority of the symptoms and signs of GCA result from involvement of the aorta and its branches intra- and extracranial. Temporal artery biopsy continues to be the cardinal diagnostic procedure despite new imaging modalities for diagnosing GCA with cranial involvement. Great advances in awareness have led to improvement in preventing irreversible vision loss due to early diagnosis.

Recent findings: The cause of GCA has not been elucidated but major progress has been made in the knowledge of its pathogenesis leading to new therapeutic targets, particularly inhibition of interleukin 6. IL 6 plays a key role in the regulation of TH17/Tregs imbalance in GCA and appears to correlate with clinical disease activity in GCA. All of this has led to the first FDA (food and drug administration) approved treatment for GCA, Tocilizumab. Abatacept and Ustekinumab are promising targets for therapy in LVV but still need further research. This paper is a review of the recent progress in the understanding of GCA pathogenesis, diagnosis, treatment, and prognosis.

Keywords: Diagnosis; Pathophysiology; Review of epidemiology; Treatment and prognosis for GCA.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Giant Cell Arteritis / diagnosis*
  • Giant Cell Arteritis / drug therapy*
  • Giant Cell Arteritis / etiology
  • Giant Cell Arteritis / immunology
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunologic Factors / therapeutic use
  • Interleukin-6 / antagonists & inhibitors
  • Molecular Targeted Therapy / methods
  • Prognosis
  • Ustekinumab / therapeutic use

Substances

  • Antibodies, Monoclonal, Humanized
  • Glucocorticoids
  • Immunologic Factors
  • Interleukin-6
  • Ustekinumab
  • tocilizumab