bone, joint, and muscle disorders
Giant Cell Arteritis
Treatment of Giant Cell Arteritis
Prednisone Low-doseaspirin Tocilizumab With treatment, most people with giant cell arteritis recover fully, but the disorder may return. Treatment of giant cell arteritis is started as soon as the disorder is suspected because, without treatment, blindness can develop. Treatment is usually started even before a biopsy is done. Treatment does not affect the biopsy results as long as the biopsy is done within 2 weeks after starting treatment. Prednisone, a corticosteroid, is effective. Initially, the dose is high to stop the inflammation in the blood vessels and prevent vision loss. After several weeks, doctors gradually reduce the dose if people are improving. Most people need to takeprednisonefor at least 2 years to control symptoms and prevent blindness.Tocilizumabis another drug that decreases inflammation. Doctors givetocilizumabalone or in combination with corticosteroids with the goal of reducing the time and/or the dose of corticosteroids that people need to take. Doctors recommend people take a low dose ofaspirindaily to help prevent strokes. Giant cell (temporal) arteritis and polymyalgia rheumatica, which often occur together, affect people over age 55 almost exclusively. These disorders become more common as people age. They are 10 times more common among people over age 80 than among those aged 50 to 59. Giant cell arteritis typically causes a throbbing headache and problems with vision (including pain in and around the eyes). Polymyalgia rheumatica makes muscles painful and stiff. Without treatment, the pain these disorders cause, whether they occur together or separately, can make everyday living miserably difficult. Also, without prompt treatment, giant cell arteritis can cause blindness. The main treatment of these disorders, corticosteroids, may be problematic in older people. These drugs can cause dramatic improvement and are essential for preventing blindness. However, they are more likely to have side effects in older people. People may retain fluids, their appetite may increase, and they may become confused. Blood sugar may increase, sometimes causing diabetes, and bone density may decrease. Blood pressure may increase. To reduce the risk of these effects, doctors reduce the dose of the corticosteroid and stop the drug as soon as possible. Older people who take corticosteroids are encouraged to take measures to help maintain bone density. They can do Weight-bearing exercise and take Faithfully continuing treatment as instructed results in complete recovery for many people. 