RESEARCH ARTICLE
Steroid-Sparing Agents in Giant Cell Arteritis
Amol Sagdeo1, Ayman Askari1, Josh Dixey1, Hana Morrissey2, *, Patrick A. Ball2
Article Information
Identifiers and Pagination:
Year: 2019Volume: 13
First Page: 61
Last Page: 71
Publisher ID: TORJ-13-61
DOI: 10.2174/1874312901913010061
Article History:
Received Date: 17/04/2019Revision Received Date: 12/06/2019
Acceptance Date: 08/07/2019
Electronic publication date: 31/07/2019
Collection year: 2019
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
Giant cell arteritis is the commonest form of medium-to-large vessel vasculitis, requiring long-term corticosteroid therapy. The short- and long-term side effects of corticosteroids are many, including weight gain, psychological effects, osteoporosis, cardiometabolic complications, and infections.
Materials and Methods:
Various agents used in place of or in combination with corticosteroids to reduce corticosteroid-related side effects were reviewed. However, considerable variation in practice was identified giving unclear guidance. This review included the most recent evidence on methotrexate, mycophenolate mofetil, azathioprine, cyclophosphamide, abatacept, and tocilizumab
Results and Discussion:
Also discussed are encouraging results with tocilizumab in GCA patients. Amongst the agents available for steroid-sparing effects, tocilizumab demonstrated the most robust data and is consequently recommended as the agent of choice for steroid-sparing, for remission induction, remission maintenance, and treating relapsing and refractory cases of GCA.