Mollan Susan Patricia, Horsburgh John, Dasgupta Bhaskar
Birmingham Neuro-Ophthalmology Unit, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham.
Institute of Metabolism and Systems Research, University of Birmingham.
Eye Brain. 2018 Jan 23;10:1-11. doi: 10.2147/EB.S127812. eCollection 2018.
Giant cell arteritis (GCA) remains a medical emergency due to the threat of permanent sight loss. High-dose glucocorticoids (GCs) are effective in inducing remission in the majority of patients, however, relapses are common which lengthen GC therapy. GC toxicity remains a major morbidity in this group of patients, and conventional steroid-sparing therapies have not yet shown enough of a clinical benefit to change the standard of care. As the understanding of the underlying immunopathophysiology of GCA has increased, positive clinical observations have been made with the use of IL-6 receptor inhibitor therapies, such as tocilizumab (TCZ). This has led to prospective randomized control trials that have highlighted the safety and efficacy of TCZ in both new-onset and relapsing GCA.
由于存在永久性视力丧失的风险，巨细胞动脉炎（GCA）仍然是一种医疗急症。大剂量糖皮质激素（GCs）对大多数患者诱导缓解有效，然而，复发很常见，这延长了GC治疗时间。GC毒性仍是这类患者的主要发病原因，传统的类固醇节省疗法尚未显示出足够的临床益处来改变治疗标准。随着对GCA潜在免疫病理生理学的认识增加，使用白细胞介素-6受体抑制剂疗法（如托珠单抗（TCZ））已取得了积极的临床观察结果。这导致了前瞻性随机对照试验，突出了TCZ在新发和复发GCA中的安全性和有效性。
