What is the treatment for giant cell arteritis?

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What is the treatment for giant cell arteritis?

Giant cell arteritis requires rapidly suppressing the vascular inflammation to prevent irreversible vision loss. The best approach is high-dose glucocorticoids administered up front. Typically, this means prednisone around 40–60 mg daily, with a plan to taper over many months as symptoms and inflammatory markers improve. If there’s urgent threat to vision or other severe complications, intravenous methylprednisolone (1 g daily for 3 days) is given initially, then switching to an oral prednisone taper. Temporal artery biopsy can confirm the diagnosis, but treatment should not wait for biopsy results because the consequence of delaying therapy can be permanent vision impairment. Aspirin does not treat the underlying inflammation and is not sufficient as sole therapy. Methotrexate or other immunosuppressants may be added in some cases as steroid-sparing agents or for refractory disease, but they are not first-line treatments. Using a low-dose prednisone regimen would not adequately control the vasculitis and leaves continued risk of ischemic complications.

Giant cell arteritis requires rapidly suppressing the vascular inflammation to prevent irreversible vision loss. The best approach is high-dose glucocorticoids administered up front. Typically, this means prednisone around 40–60 mg daily, with a plan to taper over many months as symptoms and inflammatory markers improve. If there’s urgent threat to vision or other severe complications, intravenous methylprednisolone (1 g daily for 3 days) is given initially, then switching to an oral prednisone taper. Temporal artery biopsy can confirm the diagnosis, but treatment should not wait for biopsy results because the consequence of delaying therapy can be permanent vision impairment.

Aspirin does not treat the underlying inflammation and is not sufficient as sole therapy. Methotrexate or other immunosuppressants may be added in some cases as steroid-sparing agents or for refractory disease, but they are not first-line treatments. Using a low-dose prednisone regimen would not adequately control the vasculitis and leaves continued risk of ischemic complications.

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