Giant Cell Arteritis

Updated: July 11, 2024

Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

prednisone (Rx)

40 - 60

orally

daily

prednisone (Rx)

40 - 60

orally

daily

tocilizumab

Recommended for the treatment of giant cell arteritis (GCA)

It is not recommended for patients with an ANC (absolute neutrophil count) less than 1,000/mm3, a platelet count below 50,000 mm3, or ALT/AST levels exceeding 10 times the upper limit of normal

When administered intravenously (IV), the recommended dosage is 6 mg/kg IV every 4 weeks, given alongside a tapering course of glucocorticoids
It can also be used as a standalone treatment after discontinuing glucocorticoids
If necessary, dosing may be paused to manage dose-related laboratory abnormalities, such as elevated liver enzymes, neutropenia, or thrombocytopenia
It's important not to exceed a dose of 600 mg per infusion

For subcutaneous (SC) injection, the recommended dosage is 162 mg SC weekly, alongside a tapering course of glucocorticoids
Depending on clinical considerations, it's possible to switch to 162 mg SC every other week while still following a tapering course of glucocorticoids
When transitioning from IV to SC administration, the first SC dose should replace the next scheduled IV dose