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February 2018

Tocilizumab for Giant Cell Arteritis—A New Giant Step in an Old Disease

Author Affiliations
  • 1Division of Vasculitis, Immuno-Rheumatology Center, St Luke’s International Hospital, St Luke’s International University, Tokyo, Japan
  • 2Center for Vasculitis Care and Research, Cleveland Clinic Lerner College of Medicine, Orthopaedic and Rheumatologic Institute, Cleveland, Ohio
JAMA Neurol. 2018;75(2):145-146. doi:10.1001/jamaneurol.2017.3811

Giant cell arteritis (GCA) is the most common primary systemic vasculitis in North America, often involving cranial arteries, the thoracic aorta, and subclavian and axillary arteries. Giant cell arteritis is a disease of elderly people, with the peak onset at 70 to 80 years of age. The life expectancy is not usually compromised in GCA if patients do not have severe aortitis; however, it can lead to serious morbidities, such as arteritic optic neuropathy, which can cause irreversible blindness. Glucocorticoids have been the foundation of treatment and often ameliorate clinical symptoms swiftly. However, elderly patients with GCA are often required to commit to long-term glucocorticoid therapy, which may result in serious adverse events. The clinical trials of glucocorticoid-sparing agents for GCA have been unable for a long time to guide us beyond glucocorticoid treatment.1,2

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