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BMC Rheumatol 2017 13;1. Epub 2017 Dec 13.

1Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, ST5 5BG UK.

Background: To examine the frequency of possible giant cell arteritis (GCA) symptoms (including headache, temporal/scalp tenderness, jaw claudication and visual symptoms) in newly diagnosed polymyalgia rheumatica (PMR) patients in UK primary care.

Methods: The PMR Cohort Study is a primary care inception cohort of 652 adults with newly diagnosed polymyalgia rheumatica (PMR). At baseline, participants were asked to report (yes/no) on the presence of seven potential GCA symptoms: sudden headache, tender scalp, disturbed/double vision, jaw claudication, fever, appetite loss and unintentional weight loss. Read More

BMC Rheumatol 2017 28;1. Epub 2017 Nov 28.

Division of Rheumatology, Mayo Clinic College of Medicine and Science, 200 1st St SW, Rochester, MN 55905 USA.

Giant cell arteritis (GCA) is the most common idiopathic systemic vasculitis in persons aged 50 years or greater. Treatment options for GCA, to-date, have been limited and have consisted primarily of glucocorticoids. Significant advances in the understanding of the genetic and cellular mechanisms in GCA are leading to identification of potential pathogenic targets. Read More

Curr Cardiol Rep 2019 Mar 18;21(5):34. Epub 2019 Mar 18.

Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.

Purpose Of Review: This review aims to discuss the use of fluorodeoxyglucose (FDG) positron emission tomography (PET/CT) for diagnosis and management of patients with large-vessel vasculitis (LVV).

Recent Findings: Incidence of LVV is likely underestimated, in part due to its non-specific symptoms. Nevertheless, early diagnosis of LVV is essential to initiate timely therapy in order to prevent vascular complications, such as stenoses and aneurysms. Read More

J Rheumatol 2019 Mar 15. Epub 2019 Mar 15.

From the Department of Internal Medicine, Department of Biostatistics and Department of Pathology, Caen University Hospital, Caen, France. Address correspondence to Hubert de Boysson, MD, MSc, Department of Internal Medicine, Caen University Hospital, Avenue de la Côte de Nacre, 14000 Caen, France. E-mail:

Objective: To identify characteristics and factors associated with relapse and glucocorticoid (GC) dependence in patients with giant-cell arteritis (GCA).

Methods: We retrospectively analyzed 326 consecutive patients with GCA followed for at least 12 months. Factors associated with relapse and GC dependence were identified in multivariable analyses. Read More

J Rheumatol 2019 Mar 15. Epub 2019 Mar 15.

Systemic Autoimmunity Branch, National Institutes of Health, NIAMS, Bethesda, MD, USA; Division of Rheumatology, Georgetown University, Washington DC, USA; National Institutes of Health, Clinical Center, Radiology and Imaging Sciences, Bethesda, MD, USA; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA. Address correspondence to Peter C. Grayson, MD, MSc, National Institutes of Health / NIAMS, 10 Center Drive, Building 10, 10N Rm 311D, Bethesda, MD 20892 Email:

Objective: Disease activity in large-vessel vasculitis (LVV) is traditionally assessed by clinical and serological parameters rather than vascular imaging. This study determined the effect of treatment on 18F-fluorodeoxyglose positron emission tomography (FDG-PET) vascular activity in relationship to clinical and serologic-based assessments.

Methods: Patients with giant cell arteritis (GCA) or Takayasu's arteritis (TAK) were prospectively evaluated at 6-month intervals in an observational cohort. Read More

Rheumatol Int 2019 Mar 14. Epub 2019 Mar 14.

Department of Rheumatology and Immunology, Peking University Third Hospital, No. 49, North Garden Road, Beijing, 100191, China.

Systemic vasculitis involving the breast is a rare clinical condition and may mimic breast cancer or mastitis clinically or radiographically. Here, we report a case of polyarteritis nodosa (PAN) with breast involvement and perform a literature review of published cases of systemic vasculitis affecting the breast to better understand this disorder. We report a case of PAN affecting the right breast in a young woman. Read More

Rheumatol Int 2019 Mar 14. Epub 2019 Mar 14.

Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey.

Tocilizumab (TCZ) may rarely cause hematological side effects including neutropenia and thrombocytopenia. TCZ is essentially expected to lower the fibrinogen levels to stay within the normal range, but TCZ-induced hypofibrinogenemia has been rarely reported in literature. Although it may remain asymptomatic, hypofibrinogenemia has clinical significance owing to the tendency of the condition to result in bleeding. Read More

IEEE Trans Ultrason Ferroelectr Freq Control 2019 Mar;66(3):472-480

The objective was to provide a clinical setup for photoacoustic imaging (PAI) of the temporal artery in humans and to describe the challenges encountered and methods of overcoming them. The temporal artery was examined in seven patients with suspect giant-cell arteritis (GCA), both in vivo and ex vivo, and the results were compared to that of histology. To adapt PAI to the human studies, the transducer was fixed to an adjustable arm to reduce motion artifacts, and a stepping motor was developed to enable 3-D scanning. Read More

J Clin Med 2019 Mar 12;8(3). Epub 2019 Mar 12.

Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, C.P.O. Box 8044, Seoul 03722, Korea.

The 1858T allele in the protein tyrosine phosphatase non-receptor type 22 (PTPN22) locus shows one of the strongest and most consistent genetic associations with autoimmune diseases. We synthesized all meta-analyses reporting a genetic association of the PTPN22 1858T C/T polymorphism with autoimmune diseases. This work examined their validity to discover false positive results under Bayesian methods. Read More

Clin Ophthalmol 2019 21;13:421-430. Epub 2019 Feb 21.

Ophthalmology, Harvard University, Boston, MA, USA.

Purpose: To develop and validate neural network (NN) vs logistic regression (LR) diagnostic prediction models in patients with suspected giant cell arteritis (GCA). Design: Multicenter retrospective chart review.

Methods: An audit of consecutive patients undergoing temporal artery biopsy (TABx) for suspected GCA was conducted at 14 international medical centers. Read More

Postepy Dermatol Alergol 2019 Feb 22;36(1):25-28. Epub 2019 Feb 22.

Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdansk, Gdansk, Poland.

Giant cell arteritis is the most common systemic vasculitis. It selectively affects large- and medium-sized arteries. Arterial wall inflammation leads to luminal occlusion and tissue ischemia, which cause the clinical manifestations of this vasculitis. Read More

Can J Ophthalmol 2019 Feb 11;54(1):e1-e3. Epub 2018 Jun 11.

Baylor College of Medicine, Houston, Texas; Department of Ophthalmology and the Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, N.Y; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center, Houston, Texas; Texas A & M College of Medicine, Bryan, Texas; Weill Cornell Medicine; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address:

Can J Ophthalmol 2019 Feb 12;54(1):119-124. Epub 2018 Nov 12.

Department of Ophthalmology, Queens University, Kingston, Ont.

Objective: The incidence of giant cell arteritis (GCA) is insufficiently documented for Canada, but important to ascertain for public health planning. We estimate the incidence of biopsy-proven GCA (BPGCA) in Kingston, Ontario, and for the province of Ontario.

Method: The number of cases of BPGCA was tabulated from retrospective chart review of all temporal artery biopsies (TABx) in Kingston, Ontario from 2011-15. Read More

Can J Ophthalmol 2019 Feb 31;54(1):116-118. Epub 2018 Aug 31.

Department of Ophthalmology, Harvard Medical School, Boston, MA, United States.; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ont.

Objective: Support vector machines (SVM) is a newer statistical method that has been reported to be advantageous to traditional logistic regression for clinical classification. We determine if SVM can better predict the results of temporal artery biopsy (TABx) for giant cell arteritis compared to logistic regression.

Method: A database of 530 TABx patients with 10 covariates was used and randomly split into training and test sets. Read More

Arthritis Rheumatol 2019 Mar 8. Epub 2019 Mar 8.

Departments of Rheumatology, Nuclear Medicine and Anatomical Pathology, Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia.

Objectives: PET/CT has not been well studied as a first-line test for giant cell arteritis (GCA). In part this is due to historical limitations in visualizing the cranial arteries. The Giant Cell Arteritis and PET Scan (GAPS) study assessed the accuracy of a newer generation PET/CT of the head, neck and chest for GCA. Read More

BMJ Case Rep 2019 Mar 6;12(3). Epub 2019 Mar 6.

Vasculitis, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Giant cell arteritis (GCA) is the most common vasculitis in adults and blindness is a common complication if left untreated. Oral glucocorticoids are the mainstay of treatment and if started promptly, loss of vision can usually be prevented. We present the case of a 77-year-old man who developed irreversible bilateral blindness after a confirmed diagnosis of GCA and oral steroid treatment. Read More

Autoimmun Rev 2019 Mar 4. Epub 2019 Mar 4.

Department of internal medicine, Hôtel-Dieu, CHU Nantes, Nantes, France. Electronic address:

Introduction: Juvenile temporal arteritis (JTA) is a recently-described and little-known inflammatory disease and its etiology is undetermined. Less than forty cases have been published. This paper is aimed at reporting the largest JTA series and to compare it to literature data to better evaluate its characteristics at diagnosis, its evolution and treatment options. Read More

Scand J Rheumatol 2019 Mar 6:1-7. Epub 2019 Mar 6.

g Rheumatology, Department of Medical Sciences , Uppsala University , Uppsala , Sweden.

Objective: To develop evidence-based guidelines for the management of giant cell arteritis (GCA) as a complement to guidelines in other areas of rheumatology, issued by the Swedish Society of Rheumatology.

Methods: A working group selected key areas for recommendations, reviewed the available evidence, and wrote draft guidelines. These were discussed and revised according to standard procedures within the Swedish Society of Rheumatology, including a one-day meeting open to all members. Read More

Scand J Rheumatol 2019 Mar 5:1-3. Epub 2019 Mar 5.

a Department of Rheumatology , Hospital of Southern Norway , Kristiansand , Norway.

Arthritis Rheumatol 2019 Mar 5. Epub 2019 Mar 5.

Roche Products Ltd., Welwyn Garden City, United Kingdom.

Objective: To evaluate glucocorticoid doses and serological findings in patients with giant cell arteritis (GCA) flares.

Methods: Patients with GCA were randomly assigned to receive double-blind dosing with subcutaneous tocilizumab (TCZ) 162 mg weekly plus 26-week prednisone (TCZ-QW+Pred-26), every-other-week TCZ plus 26-week prednisone (TCZ-Q2W+Pred-26), placebo plus 26-week prednisone (PBO+Pred-26), or placebo plus 52-week prednisone (PBO+Pred-52). Outcomes were prednisone dose, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) at the time of flare and remission during 52 weeks. Read More

J Infect Dis 2019 Mar 5. Epub 2019 Mar 5.

Department of Neurology, University of Colorado School of Medicine, Aurora.

Background: In temporal arteries (TAs) from giant cell arteritis patients, varicella zoster virus (VZV) is seen in perineurial cells that surround adventitial nerve bundles and form the peripheral nerve-extrafascicular tissue barrier (perineurium). We hypothesized that during VZV reactivation from ganglia, virus travels transaxonally and disrupts the perineurium to infect surrounding cells.

Methods: Mock- and VZV-infected primary human perineurial cells (HPNCs) were examined for alterations in claudin-1, E-cadherin and N-cadherin. Read More

Sci Rep 2019 Mar 4;9(1):3376. Epub 2019 Mar 4.

Nuclear Medicine Unit, Oncology and Advanced Technologies Department, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy.

MiRNAs are single stranded RNAs of 18-22 nucleotides. They are promising diagnostic and prognostic markers for several pathologies including tumors, neurodegenerative, cardiovascular and autoimmune diseases. In the present work the development and characterization of anti-miRNA radiolabeled probes based on peptide nucleic acids (PNAs) for potential non-invasive molecular imaging in vivo of giant cell arteritis are described. Read More

Yakugaku Zasshi 2019 ;139(3):491-495

Department of Hospital Pharmacy, Kansai Medical University.

Nivolumab, an anti-programmed cell death 1 antibody, has been approved for the treatment of unresectable advanced non-small-cell lung cancer (NSCLC). Although immune-related adverse events (irAEs) such as dermatologic, digestive, endocrine, hepatic, and pulmonary toxicities are known to occur upon administration of immune checkpoint inhibitors, case reports of polymyalgia rheumatica (PMR) associated with nivolumab use are rare. We report a case of an NSCLC patient who developed PMR during treatment with nivolumab and received corticosteroids. Read More

Curr Rheumatol Rev 2019 Feb 27. Epub 2019 Feb 27.

Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico,151 - 00161, Rome, . Italy.

Giant Cell Arteritis (GCA), or Horton's Arteritis, is a chronic form of vasculitis of the large and medium vessels, especially involving the extracranial branches of the carotid arteries, in particular, the temporal artery, with the involvement of the axillary, femoral and iliac arteries too. Arterial wall inflammation leads to luminal occlusion and tissue ischemia, which is responsible for the clinical manifestations of the disease. A substantial number of patients affected by GCA present head and neck symptoms, including ocular, neurological and otorhinolaryngological manifestations. Read More

Arthritis Rheumatol 2019 Mar 2. Epub 2019 Mar 2.

Brigham and Women's Hospital, Boston, Massachusetts, United States.

Imaging now plays an important role in the evaluation of giant cell arteritis (GCA). A growing body of literature supports the use of ultrasound, CT, MRI and PET to assist with diagnosis. EULAR recently recommended ultrasound or high-resolution MRI as diagnostic tests for GCA involving the superficial cranial arteries; ultrasound, MRI, CT, and PET are recommended for evaluating large arteries, with the caveat that ultrasound has limited value for detecting aortitis. Read More

J Rheumatol 2019 Mar 1. Epub 2019 Mar 1.

From the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Address correspondence to Robert F. Padera, Jr., MD, PhD, Department of Pathology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115. e-mail:

Objective: A variety of infectious agents, including varicella zoster virus (VZV), have been hypothesized to play a role in the pathogenesis of giant cell arteritis (GCA). The detectability of the virus in patients with GCA has been controversial. To further investigate an association between GCA and VZV infection, ten years of GCA cases were evaluated for VZV by immunohistochemistry (IHC). Read More

Ophthalmol Ther 2019 Mar 1. Epub 2019 Mar 1.

Birmingham Neuro-Ophthalmology, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, B15 2WB, UK.

Improving understanding of the underlying pathophysiology of giant cell arteritis (GCA) is transforming clinical management by identifying novel avenues for targeted therapies. One key area of concern for both clinicians and patients with GCA is glucocorticoid (GC) morbidity. The first randomised controlled trials of targeted treatment to reduce cumulative GC use in GCA have been published, with tocilizumab, an interleukin (IL)-6 receptor inhibitor, now the first ever licensed treatment for GCA. Read More

Ann Lab Med 2019 Jul;39(4):345-357

Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, West Midlands, UK.

The platelet-to-lymphocyte ratio (PLR) has emerged as an informative marker revealing shifts in platelet and lymphocyte counts due to acute inflammatory and prothrombotic states. PLR has been extensively examined in neoplastic diseases accompanied by immune suppression and thrombosis, which can be predicted by combined blood cell counts and their ratios. Several large observational studies have demonstrated the value of shifts in PLR in evaluating the severity of systemic inflammation and predicting infections and other comorbidities, in inflammatory rheumatic diseases. Read More

Rheumatology (Oxford) 2019 Feb 25. Epub 2019 Feb 25.

Vasculitis Expertise Center Groningen, Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Objective: GCA, a systemic vasculitis, is characterized by an IL-6-dependent acute-phase response. This response is typically suppressed by treatment rendering CRP/ESR unreliable for monitoring vascular inflammation. Also, there are no accurate biomarkers predicting a non-favourable disease course. Read More

J Clin Rheumatol 2019 Feb 19. Epub 2019 Feb 19.

Department of General Internal Medicine University Hospitals Leuven Herestraat 49, 3000 Leuven, Belgium

Ther Adv Musculoskelet Dis 2019 13;11:1759720X19827222. Epub 2019 Feb 13.

Department of Rheumatology, St. James Hospital, Dublin, Ireland Department of Rheumatology, Suite 2, Blackrock Clinic, Rock Road, Co. Dublin, Ireland.

Giant cell arteritis (GCA) is the most common form of systemic vasculitis. It is a potentially severe disease with 25% of patients suffering vision loss or stroke. Our treatment paradigm is based on glucocorticoids. Read More

J Vis Exp 2019 Feb 8(144). Epub 2019 Feb 8.

Department of Medicine, Penn State University.

Giant cell arteritis (GCA) is a chronic immune-mediated disease of medium-to-large sized arteries that affects older adults. GCA manifests with arthritis and occlusive symptoms of headaches, stroke or vision loss. Macrophages and T-helper lymphocytes infiltrate the vascular wall and produce a pro-inflammatory response that lead to vessel damage and ischemia. Read More

Arthritis Res Ther 2019 Feb 20;21(1):64. Epub 2019 Feb 20.

Massachusetts General Hospital Rheumatology Unit, Harvard Medical School, Yawkey 2, 55 Fruit Street, Boston, MA, 02114, USA.

Background: Patients with giant cell arteritis (GCA) treated with tocilizumab (TCZ) every week or every other week and prednisone tapering achieved superior rates of sustained remission to patients treated with placebo and prednisone tapering in a randomised controlled trial. Health-related quality of life (HRQOL) in patients from this trial is now reported.

Methods: Exploratory analyses of SF-36 PCS and MCS and domain scores, PtGA and FACIT-Fatigue were performed in patients treated with weekly subcutaneous TCZ 162 mg plus 26-week prednisone taper (TCZ-QW + Pred-26) or placebo plus 26-week or 52-week prednisone tapers (PBO + Pred-26 or PBO + Pred-52). Read More

Clin Immunol 2019 Feb 14. Epub 2019 Feb 14.

Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, USA.

Giant cell arteritis and Takayasu arteritis are autoimmune vasculitides that cause aneurysm formation and tissue infarction. Extravascular inflammation consists of an intense acute phase response. Deeper understanding of pathogenic events in the vessel wall has highlighted the loss of tissue protective mechanisms, the intrusion of immune cells into "forbidden territory", and the autonomy of self-renewing vasculitic infiltrates. Read More

Clin Exp Rheumatol 2019 Feb 15. Epub 2019 Feb 15.

Southend University Hospital NHS Trust, Leeds Teaching Hospitals NHS Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, UK.

Objectives: We propose a GCA probability score intended to help to risk-stratify patients referred by general practitioners with suspected GCA into those with high probability of GCA versus low probability of GCA. In this pilot study we evaluated the diagnostic accuracy of this proposed scoring system.

Methods: A scoring system was proposed based on clinical experience. Read More

Semin Ophthalmol 2019 Feb 14:1-5. Epub 2019 Feb 14.

a Tennent Institute of Ophthalmology , Gartnavel General Hospital , Glasgow , UK.

Introduction: Temporal headache often results in an Ophthalmology referral to rule out giant cell arteritis (GCA). When clinical suspicion of GCA is low, alternative diagnoses should be considered. Temporomandibular disorder (TMD) commonly causes a temporal headache. Read More

Front Immunol 2019 29;10:83. Epub 2019 Jan 29.

Department Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

Giant cell arteritis (GCA) can be classified into Cranial(C)-GCA and Large Vessel(LV)-GCA. Based on analysis of temporal arteries, GCA is postulated to be T-cell-mediated. Recently, a disturbed B-cell homeostasis was documented in newly diagnosed GCA patients. Read More

Scand J Rheumatol 2019 Feb 13:1-2. Epub 2019 Feb 13.

a Department of Internal Medicine , Tomakomai City Hospital , Tomakomai , Japan.

Eur J Case Rep Intern Med 2019 3;6(1):000997. Epub 2019 Jan 3.

Unidade Funcional de Medicina 2.1, Hospital de Santo António dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.

Immunosuppressed patients are at greater risk of unusual infections. The authors present the case of a woman with giant-cell arteritis, on oral steroids, who developed cavitating pneumonia due to co-infection with and . Reports of such co-infection are rare in the literature. Read More

Eur J Case Rep Intern Med 2018 25;5(5):000779. Epub 2018 May 25.

Department of Internal Medicine, Ikazia Ziekenhuis, Rotterdam, The Netherlands.

We describe a 58-year-old woman presenting with headache and an elevated erythrocyte sedimentation rate (ESR), who was diagnosed with and successfully treated for giant-cell arteritis (GCA). Seven months after the end of treatment, ovarian GCA was incidentally found after ovariectomy for a simple cyst. GCA of extracranial vessels like the ovarian arteries is rare. Read More

Pulmonology 2019 Feb 9. Epub 2019 Feb 9.

Internal Medicine Service, Centro Hospitalar Tondela-Viseu, E.P.E., Portugal. Electronic address:

Giant Cell Arteritis (GCA) is a common systemic vasculitis that involves medium and large arteries, most frequently extracranial branches of the carotid artery. Prompt diagnosis and treatment is essential to prevent devastating complications, such as blindness, stroke and aortic aneurysm or dissection. Typical symptoms include headache, temporal artery tenderness and jaw claudication. Read More

Clin Rheumatol 2019 Feb 9. Epub 2019 Feb 9.

Rheumatology and Rehabilitation Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

Objectives: The frequency of different vasculitides and their characteristics vary among different regions. The identification of geographic disparities of disease phenotypes helps the development of international criteria, allowing the classification of patients of different ethnicities. This study aimed to describe the frequency, characteristics, course, response to treatment, and outcome of the different adulthood vasculitides in Egypt. Read More

J Autoimmun 2019 Feb 5. Epub 2019 Feb 5.

Service de Médecine Interne-DHU i2B, Hôpital Saint-Antoine, APHP, 75012, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CdR Saint-Antoine, France. Electronic address:

Acute cerebrovascular ischemic events are a rare and severe complication of giant cell arteritis (GCA). We aimed to determine the prevalence of GCA-related stroke, the overall survival and the relapse-free survival in patients with GCA. A multicentric retrospective analysis was performed on 129 patients with GCA diagnosed between September 2010 and October 2018 in two University Hospitals. Read More

Front Immunol 2018 24;9:3129. Epub 2019 Jan 24.

Chugai Pharma Europe Ltd., Frankfurt am Main, Germany.

This paper aims to raise awareness of the different disease courses, comorbidities, and therapy situations in patients with giant cell arteritis (GCA), which require a differentiated approach and often a deviation from current treatment guidelines. With the approval of tocilizumab (TOC), which specifically binds to both soluble and membrane-bound IL-6 receptor and inhibits IL-6 receptor-mediated signaling, the spectrum of available effective treatment options has been significantly broadened. TOC yields an extensive range of possible applications that go beyond a glucocorticoid-saving effect. Read More

Med Clin (Barc) 2019 Feb 4. Epub 2019 Feb 4.

Servicio de Enfermedades Autoinmunes, Hospital Clínic, Universitat de Barcelona, Barcelona, España.

Imaging has become an essential tool in the management of patients with giant cell arteritis. Cranial involvement detected by Doppler ultrasonography is an unquestionable diagnostic finding. Imaging of the aorta and its branches with positron emission tomography, computed tomography angiography or magnetic resonance imaging may also have a role in diagnosis and in the assessment of disease activity and response to treatment, but standardisation and validation are still needed before their widespread use as an outcome measure. Read More

Arthritis Rheumatol 2019 Feb 7. Epub 2019 Feb 7.

Division of Rheumatic and Immunologic Diseases, Center for Vasculitis Care and Research, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Objective: Non-infectious aortitis may occur in the context of a recognized systemic disease or as a topographically-limited lesion without systemic features, termed clinically-isolated aortitis (CIA). From a large population of patients in a single center dedicated to aortic diseases, we have sought to better define and stress the limitations of this diagnostic category, and suggest recommendations for care.

Methods: Records of patients undergoing thoracic aortic surgery (1996-2012) at the Cleveland Clinic were reviewed to identify 196 with histopathology-proven aortitis. Read More

Rev Med Chil 2018 Nov;146(11):1356-1360

Departamento de Ciencias Neurológicas Oriente, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

Giant cell arteritis is the most common vasculitis in patients aged over 50 years. We report an 89-year-old woman with significant weight loss and persistent frontal-occipital headaches lasting two months. The neurological examination at admission identified a decrease in visual acuity of the left eye, paralysis of the third cranial nerve of the right eye and alterations of body motility without objective signs of damage of the motor or sensitive pathways. Read More

Neuroophthalmology 2019 Feb 19;43(1):18-25. Epub 2018 Jun 19.

Harvard University Ophthalmology, Beth Israel Deaconness, Boston, Massachusetts, USA.

Purpose: To determine the positive yield (utility rate) of temporal artery biopsy (TAB) in patients with suspected giant cell arteritis (GCA).

Study Design: Systematic review (CRD42017078508) and meta-regression.

Materials And Methods: All articles concerning TAB for suspected GCA with English language abstracts from 1998 to 2017 were retrieved. Read More

Rheumatol Ther 2019 Mar 1;6(1):77-88. Epub 2019 Feb 1.

Genentech, Inc, South San Francisco, CA, USA.

Introduction: The safety profile of tocilizumab (TCZ) in patients with rheumatoid arthritis (RA) is well established. TCZ was approved to treat giant cell arteritis (GCA) in 2017 in the USA and Europe, and its safety profile in patients with GCA continues to be defined. The objective of this analysis was to examine incidence rates (IRs) of adverse events of special interest (AESI) occurring during the TCZ clinical development program and in healthcare claims data in patients with GCA or RA. Read More