Optimal management of giant cell arteritis and polymyalgia rheumatica

Optimal management of giant cell arteritis and polymyalgia rheumatica

4 April 2012 | Rodger Charlton
This article, published in *Therapeutics and Clinical Risk Management* on April 4, 2012, by Rodger Charlton from Swansea University, Wales, discusses the optimal management of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR). GCA and PMR are clinical diagnoses without a "gold standard" serological or histological test, and other conditions can mimic these syndromes. Treatment with 10–20 mg of prednisolone daily is recommended for PMR, while 40–60 mg daily is suggested for GCA when temporal arteritis is suspected. Ocular involvement of GCA should be treated as a medical emergency to prevent blindness, and steroids should be administered immediately. There are no absolute guidelines for the dose or duration of prednisolone, and treatment should be adjusted based on individual responses and the risks associated with high-dose and long-term glucocorticoids. Low-dose aspirin may reduce complications, and clinicians should be aware of the increased incidence of large-artery complications in GCA. The article emphasizes the need for further research, particularly in radiological imaging, to improve diagnosis and treatment.This article, published in *Therapeutics and Clinical Risk Management* on April 4, 2012, by Rodger Charlton from Swansea University, Wales, discusses the optimal management of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR). GCA and PMR are clinical diagnoses without a "gold standard" serological or histological test, and other conditions can mimic these syndromes. Treatment with 10–20 mg of prednisolone daily is recommended for PMR, while 40–60 mg daily is suggested for GCA when temporal arteritis is suspected. Ocular involvement of GCA should be treated as a medical emergency to prevent blindness, and steroids should be administered immediately. There are no absolute guidelines for the dose or duration of prednisolone, and treatment should be adjusted based on individual responses and the risks associated with high-dose and long-term glucocorticoids. Low-dose aspirin may reduce complications, and clinicians should be aware of the increased incidence of large-artery complications in GCA. The article emphasizes the need for further research, particularly in radiological imaging, to improve diagnosis and treatment.
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[slides and audio] Optimal management of giant cell arteritis and polymyalgia rheumatica