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
  • [51] Ocular manifestations of giant cell arteritis
    Hayreh, SS
    Podhajsky, PA
    Zimmerman, B
    [J]. AMERICAN JOURNAL OF OPHTHALMOLOGY, 1998, 125 (04) : 509 - 520
  • [52] Occult giant cell arteritis: Ocular manifestations
    Hayreh, SS
    Podhajsky, PA
    Zimmerman, B
    [J]. AMERICAN JOURNAL OF OPHTHALMOLOGY, 1998, 125 (04) : 521 - 526
  • [54] A strong initial systemic inflammatory response is associated with higher corticosteroid requirements and longer duration of therapy in patients with giant-cell arteritis
    Hernández-Rodríguez, J
    García-Martínez, A
    Casademont, J
    Filella, X
    Esteban, MJ
    López-Soto, A
    Fernández-Solà, J
    Urbano-Márquez, A
    Grau, JM
    Cid, MC
    [J]. ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH, 2002, 47 (01): : 29 - 35
  • [55] Infliximab for maintenance of glucocorticosteroid-induced remission of giant cell arteritis - A randomized trial
    Hoffman, Gary S.
    Cid, Maria C.
    Rendt-Zagar, Karen E.
    Merkel, Peter A.
    Weyand, Cornelia M.
    Stone, John H.
    Salvarani, Carlo
    Xu, Weichun
    Visvanathan, Sudha
    Rahman, Mahboob U.
    [J]. ANNALS OF INTERNAL MEDICINE, 2007, 146 (09) : 621 - 630
  • [56] A multicenter, randomized, double-blind, placebo-controlled trial of adjuvant methotrexate treatment for giant cell arteritis
    Hoffman, GS
    Cid, MC
    Hellman, DB
    Guillevin, L
    Stone, JH
    Schousboe, J
    Cohen, P
    Calabrese, LH
    Dickler, H
    Merkel, PA
    Fortin, P
    Flynn, JA
    Locker, GA
    Easley, KA
    Schned, E
    Hunder, GG
    Sneller, MC
    Tuggle, C
    Swanson, H
    Hernández-Rodríguez, J
    Lopez-Soto, A
    Bork, D
    Hoffman, DB
    Kalunian, K
    Klashman, D
    Wilke, WS
    Scheetz, RJ
    Mandell, BF
    Fessler, BJ
    Kosmorsky, G
    Prayson, R
    Luqmani, RA
    Nuki, G
    McRorie, E
    Sherrer, Y
    Baca, S
    Walsh, B
    Ferland, D
    Soubrier, M
    Choi, HK
    Gross, W
    Segal, AM
    Ludivico, C
    Puechal, X
    [J]. ARTHRITIS AND RHEUMATISM, 2002, 46 (05): : 1309 - 1318
  • [57] HUNDER GG, 1990, ARTHRITIS RHEUM, V33, P1122
  • [58] Combined treatment of giant-cell arteritis with methotrexate and prednisone -: A randomized, double-blind, placebo-controlled trial
    Jover, JA
    Hernández-García, C
    Morado, IC
    Vargas, E
    Bañares, A
    Fernández-Gutiérrez, B
    [J]. ANNALS OF INTERNAL MEDICINE, 2001, 134 (02) : 106 - 114
  • [59] Kötter I, 2012, CLIN EXP RHEUMATOL, V30, pS114
  • [60] Kremers HM, 2005, J RHEUMATOL, V32, P65