The Treatment of Giant Cell Arteritis in Different Clinical Settings

Front Immunol. 2019 Jan 24:9:3129. doi: 10.3389/fimmu.2018.03129. eCollection 2018.

Abstract

This paper aims to raise awareness of the different disease courses, comorbidities, and therapy situations in patients with giant cell arteritis (GCA), which require a differentiated approach and often a deviation from current treatment guidelines. With the approval of tocilizumab (TOC), which specifically binds to both soluble and membrane-bound IL-6 receptor and inhibits IL-6 receptor-mediated signaling, the spectrum of available effective treatment options has been significantly broadened. TOC yields an extensive range of possible applications that go beyond a glucocorticoid-saving effect. In this context, the treatment of GCA is dependent on the disease course as well as the associated comorbidities. The different stages of GCA in association to co-morbidities require a detailed treatment strategy.

Keywords: clinical settings; comorbidity; giant cell arteritis; glucocorticoids; relapse; tocilizumab.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / pharmacology
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Comorbidity
  • Drug Resistance
  • Giant Cell Arteritis / drug therapy*
  • Giant Cell Arteritis / epidemiology
  • Giant Cell Arteritis / immunology
  • Giant Cell Arteritis / pathology
  • Glucocorticoids / pharmacology
  • Glucocorticoids / therapeutic use*
  • Humans
  • Randomized Controlled Trials as Topic
  • Receptors, Interleukin-6 / antagonists & inhibitors
  • Receptors, Interleukin-6 / immunology
  • Recurrence
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Glucocorticoids
  • Receptors, Interleukin-6
  • tocilizumab