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KMID : 0911820220230020015
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Korean Journal of Headache
2022 Volume.23 No. 2 p.15 ~ p.20
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Update on Treatment of Giant Cell Arteritis
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Kang Mi-Kyoung
Kim Yoo-Hwan
Son Kyeong-Min
Cho Soo-Jin
Kim Ji-Young
Sohn Jong-Hee
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Abstract
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Giant cell arteritis (GCA), also known as temporal arteritis, is the most common primary vasculitis in adults over 50 years. It has a very low prevalence in Asians, but in about 20% of patients experience serious complications such as vision loss. When GCA is suspected, the clinician should know the tests for early diagnosis and appropriate treatments for the patient's quality of life. Temporal artery biopsy is recommended for the confirmation of GCA, but it is invasive, and the sensitivity and specificity of each test are different. Recently, the halo sign of ultrasonography and the findings of vasculitis on high-resolution vascular wall magnetic resonance imaging have been presented as histological evidence. The main treatment for GCA is glucocorticoids, but they need to be tapered due to several side effects. Adjunctive therapy is azathioprine or methotrexate, which has sparing effect of glucocorticoids. The therapeutic effect and safety of tocilizumab have been reported in a recent clinical study, and as reimbursement becomes possible in Korea, the choice of treatment for GCA is expected to expand.
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KEYWORD
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Giant cell arteritis, Temporal arteritis, Anterior ischemic optic neuropathy, Ultrasonography, Glucocorticoid, Tocilizumab
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