Treatment of giant cell arteritis (GCA) 1st Line Strategy - GC 0.7 mg/kg/day, except for: • Aortitis complicated by aneurysm and/or dissection - 1 mg/kg/day • Ischemic complications - 1 mg/kg/day (AION/CRAO, scalp necrosis, stroke) Relapses - When to start GC-sparing agents? • 1st relapse: Incr GC if dose <7.5 mg/d, start MTX or TCZ in case of GC-dependence 27.5 mg/jd • 2nd relapse: MTX and/or TCZ if never received; or MTX -> TCZ or vice-versa • >2 relapses: discuss therapeutic trials if TCZ and MTX already received Which GC-Sparing Agents? • Methotrexate : 7.5 to 15 mg (or 20 mg) per week orally or SC for > 1 year • Tocilizumab : 162 mg weekly SC for > 1 year By Thibault Ghesquière via Dr. Benjamin Terrier @TerrierBen #giantcell #arteritis #GCA #Treatment #Management #Relapses #Indications #rheumatology #2ndline
