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GCA Diagnosis and Treatment Is Progressing, Researchers Say
Giant cell arteritis (GCA) diagnosis can no longer be reliant on temporal artery biopsy, a recent review reported.
The researchers also determined that the incidence of the disease has grown over the years, and to avoid disease complications, more may be required than treatment with corticosteroids.
“Modern vascular imaging techniques and targeted immunologic therapies are heralding a new era for the disease, in which practitioners will hopefully be able to diagnosis it with greater accuracy and treat it with less ischemic complications and iatrogenic side effects,” the authors reported.
Researchers observed the manifestations of GCA now may include links to cardiac disease, limb claudication, and aortitis, as well as further visual complications. Some clinical presentations of headache, scalp tenderness, fever, jaw claudication, and other systemic symptoms may serve as markers for GCA. However, diagnosis can be difficult in cases in which the more “classic” symptoms are lacking.
Researchers noted the importance of reviewing the evolving disease manifestations as a way to further understand the immunological mechanisms underlying the disease, and ultimately aid in the search for novel therapies.
“There is increasing evidence supporting the use of Doppler ultrasound, dedicated post-contrast T1-weighted spin echo MRI of the scalp arteries, and PET scan, which can together improve our diagnostic accuracy in cases in which temporal artery biopsy is either inconclusive or not feasible,” the authors concluded. “Advances in our understanding of the immunological cascades underlying the disease have helped guide our search for steroid-sparing treatments for the GCA, the most important of which has been the IL-6 receptor antibody inhibitor tocilizumab, which has been shown to reduce cumulative steroid dose in a large multicenter, placebo-controlled prospective study. Other biologic agents, such as abatacept and ustekinumab, have shown promise in smaller studies.”
—Angelique Platas
Reference
Dinkin M, Johnson E. One giant step for giant cell arteritis: updates in diagnosis and treatment. Curr Treat Options Neurol 2021;23(2):6.
