Document Detail


Treatment of giant cell arteritis.
MedLine Citation:
PMID:  23562185     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Corticosteroids (CS) remain the main treatment for giant cell arteritis (GCA). The choice of initial prednisone dosage (from 0.5 to 1 mg/kg/d) takes into account the disease severity and comorbidities in order to reduce the drug side effects. Low-dose aspirin may benefit to patients suffering ischemic complications or with multiple cardiovascular risk factors. Randomised controlled trials are necessary to precise its benefit-to-risk ratio. Methotrexate has a moderate corticosteroid sparing effect but it does not prevent cephalic complications and there is no evidence of a reduced frequency of CS adverse effects with this drug. Hydroxychloroquine and infliximab or adalimumab did not prevent relapses in double blind controlled trials. High doses of intravenous methylprednisolone are often prescribed for severe ischemic complications though there is no evidence that such doses are superior to classical doses. In corticosteroid dependent patients, the benefit-to-risk ratio of immunosuppressive drugs is unknown. Dapsone is no longer prescribed due to severe adverse effects. Efficacy of tocilizumab is very promising but its benefit-to-risk ratio in old people is largely unknown. Finding a well tolerated corticosteroid sparing drug remains a challenge and further studies are necessary to reduce the long term rate of cardiovascular events and the burden of CS adverse effects.
Authors:
L Sailler; G Pugnet; B Bienvenu
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-4-4
Journal Detail:
Title:  La Revue de medecine interne / fondee ... par la Societe nationale francaise de medecine interne     Volume:  -     ISSN:  1768-3122     ISO Abbreviation:  Rev Med Interne     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-4-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8101383     Medline TA:  Rev Med Interne     Country:  -    
Other Details:
Languages:  FRE     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.
Affiliation:
Service de médecine interne, hôpital Purpan, CHU de Toulouse, pavillon Turiaf, place Dr-Baylac, 31059 Toulouse cedex 09, France. Electronic address: sailler.l@chu-toulouse.fr.
Vernacular Title:
Traitement de la maladie de Horton.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Advanced sleep schedules affect circadian gene expression in young adults with delayed sleep schedul...
Next Document:  Transplantation of allogenic fetal membrane-derived mesenchymal stem cells protect against ischemia-...