Managing of giant cell arteritis and polymyalgia rheumatica

被引:6
作者
Gonzalez-Gay, Miguel A. [1 ,2 ,3 ]
Castaneda, Santos [4 ]
机构
[1] Univ Cantabria, Dept Med, Santander, Spain
[2] IDIVAL, Epidemiol Genet & Atherosclerosis Res Grp Syst In, Santander, Spain
[3] Hosp Univ Marques de Valdecilla, Div Rheumatol, C Ave Valdecilla S-N, Santander 39008, Spain
[4] Univ Autonoma Madrid, Hosp la Princesa, Div Rheumatol, IIS IP, Madrid, Spain
来源
EXPERT OPINION ON ORPHAN DRUGS | 2016年 / 4卷 / 11期
关键词
Giant cell arteritis; polymyalgia rheumatica; relapses; prednisone; methotrexate; infliximab; tocilizumab; SEVERE ISCHEMIC COMPLICATIONS; PLACEBO-CONTROLLED TRIAL; POPULATION-BASED COHORT; TERM-FOLLOW-UP; DOUBLE-BLIND; NORTHWESTERN SPAIN; RHEUMATISM/AMERICAN COLLEGE; CEREBROVASCULAR ACCIDENTS; TAKAYASU ARTERITIS; EUROPEAN LEAGUE;
D O I
10.1080/21678707.2016.1244480
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are relatively common and often overlapping conditions in individuals older than 50years from Western countries. Treatment yields improvement of symptoms in both conditions and reduction of the risk of permanent visual loss in GCA. Relapses constitute an important point of concern in these patients.Areas covered: This review focuses on the main therapeutic strategies for the management of both conditions. The use of conventional immunosuppressive drugs and the new biologic agents for the management of the disease are discussed.Expert opinion: An initial dose of prednisone of 40-60mg/day is useful to improve symptoms and to reduce the risk of blindness in GCA. In turn, 10-20mg/prednisone a day is generally sufficient to yield clinical improvement in most patients with PMR. A condition different from isolated PMR must be considered when resolution of PMR features is not achieved within 7days after the onset of corticosteroids. Relapses are common - generally when the dose of prednisone is below than 7.5-10mg/day. Methotrexate is the most commonly used corticosteroid sparing agent. Biologic agents, such as the recombinant humanized anti-IL-6 receptor antibody tocilizumab, have been incorporated into the management of these conditions, in particular of GCA. Osteoporosis prophylaxis is also recommended.
引用
收藏
页码:1133 / 1144
页数:12
相关论文
共 109 条
  • [41] Best practices and uncertainties in the management of PMR
    Gonzalez-Gay, Miguel A.
    Llorca, Javier
    [J]. NATURE REVIEWS RHEUMATOLOGY, 2016, 12 (01) : 3 - 4
  • [42] Giant Cell Arteritis and Polymyalgia Rheumatica: an Update
    Gonzalez-Gay, Miguel A.
    Pina, Trinitario
    [J]. CURRENT RHEUMATOLOGY REPORTS, 2015, 17 (02)
  • [43] Giant cell arteritis: Epidemiology, diagnosis, and management
    Gonzalez-Gay M.A.
    Martinez-Dubois C.
    Agudo M.
    Pompei O.
    Blanco R.
    Llorca J.
    [J]. Current Rheumatology Reports, 2010, 12 (6) : 436 - 442
  • [44] Epidemiology of Giant Cell Arteritis and Polymyalgia Rheumatica
    Gonzalez-Gay, Miguel A.
    Vazquez-Rodriguez, Tomas R.
    Lopez-Diaz, Maria J.
    Miranda-Filloy, Jose A.
    Gonzalez-Juanatey, Carlos
    Martin, Javier
    Llorca, Javier
    [J]. ARTHRITIS CARE & RESEARCH, 2009, 61 (10) : 1454 - 1461
  • [45] Strokes at Time of Disease Diagnosis in a Series of 287 Patients With Biopsy-Proven Giant Cell Arteritis
    Gonzalez-Gay, Miguel A.
    Vazquez-Rodriguez, Tomas R.
    Gomez-Acebo, Ines
    Pego-Reigosa, Robustiano
    Lopez-Diaz, Maria J.
    Vazquez-Trinanes, Matilde C.
    Miranda-Filloy, Jose A.
    Blanco, Ricardo
    Dierssen, Trinidad
    Gonzalez-Juanatey, Carlos
    Llorca, Javier
    [J]. MEDICINE, 2009, 88 (04) : 227 - 235
  • [46] GONZALEZGAY MA, 1995, REV RHUM, V62, P539
  • [47] Polymyalgia rheumatica without significantly increased erythrocyte sedimentation rate - A more benign syndrome
    GonzalezGay, MA
    RodriguezValverde, V
    Blanco, R
    FernandezSueiro, JL
    Armona, J
    Figueroa, M
    MartinezTaboada, VM
    [J]. ARCHIVES OF INTERNAL MEDICINE, 1997, 157 (03) : 317 - 320
  • [48] Management of giant cell arteritis - Our 27-year clinical study: New light on old controversies
    Hayreh, SS
    Zimmerman, B
    [J]. OPHTHALMOLOGICA, 2003, 217 (04) : 239 - 259
  • [49] Visual deterioration in giant cell arteritis patients while on high doses of corticosteroid therapy
    Hayreh, SS
    Zimmerman, B
    [J]. OPHTHALMOLOGY, 2003, 110 (06) : 1204 - 1215
  • [50] Visual improvement with corticosteroid therapy in giant cell arteritis. Report of a large study and review of literature
    Hayreh, SS
    Zimmerman, B
    Kardon, RH
    [J]. ACTA OPHTHALMOLOGICA SCANDINAVICA, 2002, 80 (04): : 355 - 367