Kraemer Markus, Becker Jana, Bley Thorsten Alexander, Steinbrecher Andreas, Minnerup Jens, Hellmich Bernhard
Klinik für Neurologie, Alfried Krupp Krankenhaus Rüttenscheid, Alfried-Krupp-Straße 21, 45130, Essen, Deutschland.
Klinik für Neurologie, Medizinische Fakultät, Heinrich Heine Universität Düsseldorf, Düsseldorf, Deutschland.
Nervenarzt. 2022 Aug;93(8):819-827. doi: 10.1007/s00115-021-01216-8. Epub 2021 Nov 3.
Giant cell arteritis (GCA) is the most common idiopathic systemic vasculitis in the age group over 50 years. It requires prompt diagnostics and treatment to avoid severe complications, such as visual loss or stroke. The tendency to relapse makes a glucocorticoid (GC) treatment necessary for several years and sometimes lifelong, which increases the risk of GC-induced long-term side effects. Therefore, additive GC-sparing treatment is recommended in the majority of patients. For this purpose, the anti-IL‑6 receptor antibody tocilizumab is available as an approved substance for subcutaneous application; alternatively, methotrexate (MTX) can be used (off-label).
巨细胞动脉炎（GCA）是50岁以上人群中最常见的特发性系统性血管炎。它需要及时诊断和治疗以避免严重并发症，如视力丧失或中风。复发倾向使得糖皮质激素（GC）治疗有必要持续数年，有时甚至是终身治疗，这增加了GC诱导的长期副作用的风险。因此，大多数患者建议采用辅助性的糖皮质激素节省治疗。为此，抗IL-6受体抗体托珠单抗是一种已获批准可皮下应用的药物；另外，也可以使用甲氨蝶呤（MTX）（非适应证用药）。
