What Is the Treatment of Giant Cell Arteritis? First-Line Management
Giant cell arteritis (GCA) is a medical emergency. The imminent risk of sight loss and other ischaemic events means treatment must begin immediately on diagnosis — delays are not acceptable. Management typically requires multidisciplinary collaboration.
Treatment Approach
First-line management involves glucocorticoid therapy, initiated without delay. The full protocol — including the complete clinical algorithm, therapeutic options, and sequencing — is available via the link below.
Treatment Goals
The primary target is remission: absence of clinical symptoms of giant cell arteritis together with normalisation of acute phase reactants, particularly ESR and CRP. Disease activity is monitored as frequently as every 1–4 weeks until remission is achieved.
References
DOI: 10.1136/ard-2022-223429
- Glucocorticoids (GC) are the standard treatment for GCA and PMR.
- GCA is a medical emergency because of the imminent risk of sight loss and other ischaemic events and, therefore, requires immediate treatment; management usually requires multidisciplinary collaboration.
- The treatment target of GCA and PMR should be remission; remission is the absence of clinical symptoms and systemic inflammation.
- They most commonly include the absence of clinical symptoms related to GCA and/or PMR and the normalisation of acute phase reactants, particularly ESR and CRP.
- Disease activity in GCA and PMR should be monitored regularly, as frequently as every 1–4 weeks until remission has been achieved, and at longer monitoring intervals (eg, between 3 and 6 months) in patients in stable remission on therapy; monitoring of patients off therapy should be discussed on an individual basis.