Therapeutic update in large vessel vasculitides

Abstract

The term large vessel vasculitidis includes two distinct clinical entities: Takayasu's arteritis and giant cell arteritis. Takayasu's arteritis mainly affects children and women under 40 years, affecting the aorta and its major branches. Its incidence in Southern Europe is low. Giant cell arteritis is the most common vasculitis in those 60. Its incidence in the European population is greater than that of Takayasu's arteritis. It mainly affects the extracranial vessels, especially those derived from the carotid artery. Both conditions are characterized by inflammation of the vessel wall, this causing structural damage and the expression of different clinical manifestations. The treatment of choice of both conditions is based on high-dose glucocorticoids associated, in some cases, to immunosuppressants. Biologic agents have been reserved for cases refractory to conventional therapies.

Keywords: Anti-TNF agents; Arteritis de Takayasu; Arteritis de células gigantes; Fármacos anti-TNF; Giant cell arteritis; Large-vessel vasculitis; Takayasu's arteritis; Tocilizumab; Vasculitis de grandes vasos.