Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria.
Department of Autoimmune Diseases, Hospital Clinic, University of Barcelona, Insitut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain.
Lancet Rheumatol. 2024 Jun;6(6):e384-e396. doi: 10.1016/S2665-9913(24)00024-9. Epub 2024 Apr 1.
Since its first clinical description in 1890, extensive research has advanced our understanding of giant cell arteritis, leading to improvements in both diagnosis and management for affected patients. Imaging studies have shown that the disease frequently extends beyond the typical cranial arteries, also affecting large vessels such as the aorta and its proximal branches. Meanwhile, advances in comprehending the underlying pathophysiology of giant cell arteritis have given rise to numerous potential therapeutic agents, which aim to minimise the need for glucocorticoid treatment and prevent flares. Classification criteria for giant cell arteritis, as well as recommendations for management, imaging, and treat-to-target have been developed or updated in the last 5 years, and current research encompasses a broad spectrum covering basic, translational, and clinical research. In this Series paper, we aim to discuss the current understanding of giant cell arteritis with cranial manifestations, describe the clinical approach to this condition, and explore future directions in research and patient care.
自 1890 年首次临床描述以来,大量研究提高了我们对巨细胞动脉炎的认识,从而改善了受影响患者的诊断和治疗。影像学研究表明,该疾病经常超出典型的颅动脉范围,还会影响主动脉及其近端分支等大血管。同时,对巨细胞动脉炎潜在病理生理学的理解的进步催生了许多潜在的治疗药物,这些药物旨在减少对糖皮质激素治疗的需求并预防病情发作。过去 5 年来,巨细胞动脉炎的分类标准以及管理、影像学和靶向治疗的建议已经得到制定或更新,目前的研究涵盖了从基础研究、转化研究到临床研究的广泛领域。在本系列论文中,我们旨在讨论具有颅面表现的巨细胞动脉炎的当前认识,描述对这种疾病的临床处理方法,并探讨研究和患者护理的未来方向。