Department of Rheumatology and Internal Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Rheumatology and Internal Medicine, Sfânta Maria Clinical Hospital Bucharest, 011172 Bucharest, Romania.
Medicina (Kaunas). 2024 Feb 26;60(3):400. doi: 10.3390/medicina60030400.
Giant cell arteritis (GCA) is a large-vessel vasculitis affecting elderly patients and targeting the aorta and its main branches, leading to cranial and extracranial manifestations. The mechanism behind the ischemia is a granulomatous-type inflammation with potentially critical lesions, including visual loss involving the ophthalmic artery. Despite significant progress in unraveling the pathophysiology of this disease, treatment options still rely on glucocorticoids (GCs) to overcome active vascular lesions and disease flares. However, uncertainty still revolves around the optimal dose and tapering rhythm. Few corticosteroid-sparing agents have proven useful in GCA, namely, methotrexate and tocilizumab, benefiting cumulative GC dose and relapse-free intervals. The future looks promising with regard to using other agents like abatacept and Janus-kinase inhibitors or blocking the granulocyte-macrophage colony-stimulating factor receptor.
巨细胞动脉炎（GCA）是一种影响老年患者的大血管血管炎，靶向主动脉及其主要分支，导致颅内外表现。缺血的机制是一种可能导致严重病变的肉芽肿样炎症，包括涉及眼动脉的视力丧失。尽管在揭示这种疾病的病理生理学方面取得了重大进展，但治疗选择仍然依赖于糖皮质激素（GCs）来克服活跃的血管病变和疾病发作。然而，关于最佳剂量和逐渐减少的节奏仍然存在不确定性。少数皮质类固醇节约剂已被证明对 GCA 有效，即甲氨蝶呤和托珠单抗，可获益于累积 GC 剂量和无复发间隔。在使用其他药物方面，如阿巴西普和 Janus-kinase 抑制剂或阻断粒细胞-巨噬细胞集落刺激因子受体方面，未来前景看好。
