Dev Hücreli Arterit
Özet
Temporal arterit olarak da bilinen dev hücreli arterit (DHA), Takayasu arteriti ve Cogan sendromu ile birlikte büyük damar vaskülitleri olarak sınıflandırılmaktadır ve aort veya dallarının inflamasyonu ile karakterizedir. DHA, 50 yaşın üzerindeki insanları etkileyen, en sık görülen büyük damar vaskülitidir. DHA, aort veya dallarını (çoğunlukla subklavian ve aksiller arterler, karotid arterler ve dalları ve vertebral arterleri) etkiler.
DHA’nin farmakolojik tedavisinde iki aşama vardır. Başlangıçtaki vasküler inflamasyonu baskılamayı amaçlayan ve tipik olarak yüksek dozlarda glukokortikoid gerektiren remisyon indüksiyon tedavisi ve sonrasında remisyon idame tedavisidir. İdame tedavide, nükslerde, dirençli DHA hastalarında veya glukokortikoid ile ilişkili yan etki riski yüksek olan hastalarda, hastalık modifiye edici ajanların veya biyolojik tedavilerin kullanılmasını önerilmektedir.
Revaskülarizasyon prosedürleri, büyük damar vaskülitli hastaların yönetiminde önemli bir role sahiptir. Kontrol edilemeyen renovasküler hipertansiyon, kritik karotis veya vertebral arter stenozunda optimal farmakolojik tedaviye rağmen devam eden iskemik bulguların varlığı durumlarında gerekli olabilir. Perkütan anjiyoplasti veya açık cerrahi yaklaşımların her ikisi de mümkündür ve sonuçlar genel olarak benzerdir.
Giant cell arteritis (GCA), also known as temporal arteritis, is classified along with Takayasu arteritis and Cogan syndrome as large vessel vasculitis and is characterized by inflammation of the aorta or its branches. GCA is the most common large vessel vasculitis, affecting people over 50 years of age. DHA affects the aorta or its branches (mostly the subclavian and axillary arteries, carotid arteries and their branches, and vertebral arteries).
There are two stages in the pharmacological treatment of DHA. It is remission induction therapy followed by remission maintenance therapy that aims to suppress initial vascular inflammation and typically requires high doses of glucocorticoids. In maintenance therapy, in relapses, in patients with resistant GCA, or in patients with a high risk of glucocorticoid-related side effects, the use of disease-modifying agents or biological therapies is recommended.
Revascularization procedures have an important role in the management of patients with large vessel vasculitis. It may be necessary in cases of uncontrolled renovascular hypertension, critical carotid or vertebral artery stenosis, and persistent ischemic findings despite optimal pharmacological treatment. Percutaneous angioplasty or open surgical approaches are both possible, and the results are generally similar.
Referanslar
Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65:1–11.
Mahr A, Belhassen M, Paccalin M, et al. Characteristics and management of giant cell arteritis in France: a study based on nationa health insurance claims data. Rheumatol Oxf Engl 2020;59:120–8, http://dx.doi.org/10.1093/rheumatology/kez251.
Samson M, Corbera-Bellalta M, Audia S, et al. Recent advances in our understanding of giant cell arteritis pathogenesis. Autoimmun Rev 2017;16:833–44, http://dx.doi.org/10.1016/j.autrev.2017.05.014.
Horton BT, Magath TB and Brown GE. Arteritis of the temporal vessels: a previously undescribed form. Archives of internal medicine. 1934;53:400–409.
Kogstad OA. Polymyalgia rheumatica and its relation to arteritis temporalis. Acta Med Scand. 1965;178:591–8.
Gilmour JR. Giant cell chronic arteritis. J Pathol Bacteriol. 1941;53:263–277.
Hamrin B, Jonsson N and Hellsten S. Polymyalgia Arteritica. Annals of the rheumatic diseases. 1968;27:397–405.
Blockmans D, de Ceuninck L, Vanderschueren S, et al.. Repetitive 18F-fluorodeoxyglucose positron emission tomography in giant cell arteritis: a prospective study of 35 patients. Arthritis Rheum. 2006;55:131–7.
Schmidt WA, Natusch A, Moller DE, et al. Involvement of peripheral arteries in giant cell arteritis: a color Doppler sonography study. Clin Exp Rheumatol. 2002;20:309–18.
Hellmich B, Agueda A, Monti S et al. RA. 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Annals of the rheumatic diseases. 2020;79:19–30.
Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis.Arthritis Rheum.1990; 33:1122–1128. doi: 10.1002/art.1780330810CrossrefMedlineGoogle Scholar
Muratore F, Kermani TA, Crowson CS, et al. Large-vessel giant cell arteritis: a cohort study.Rheumatology (Oxford).2015; 54:463–470. doi: 10.1093/rheumatology/keu329CrossrefMedlineGoogle Scholar
de Boysson H, Daumas A, Vautier M, et al. Large-vessel involvement and aortic dilation in giant-cell arteritis. A multicenter study of 549 patients.Autoimmun Rev.2018; 17:391–398. doi: 10.1016/j.autrev.2017.11.029CrossrefMedlineGoogle Scholar
Vilaseca J, González A, Cid MC, et al. Clinical usefulness of temporal artery biopsy.Ann Rheum Dis.1987; 46:282–285. doi: 10.1136/ard.46.4.282CrossrefMedlineGoogle Scholar
Ponte C, Serafim AS, Monti S, et al. Early variation of ultrasound halo sign with treatment and relation with clinical features in patients with giant cell arteritis.Rheumatology (Oxford). 2020; 59:3717–3726. doi: 10.1093/rheumatology/keaa196CrossrefMedlineGoogle Scholar
Prieto-González S, Arguis P, García-Martínez A, et al. Large vessel involvement in biopsy-proven giant cell arteritis: prospective study in 40 newly diagnosed patients using CT angiography.Ann Rheum Dis.2012; 71:1170–1176. doi: 10.1136/annrheumdis-2011-200865CrossrefMedlineGoogle Scholar
Nuenninghoff DM, Hunder GG, Christianson TJ, et al. Incidence and predictors of large-artery complication (aortic aneurysm, aortic dissection, and/or large-artery stenosis) in patients with giant cell arteritis: a population-based study over 50 years.Arthritis Rheum.2003; 48:3522–3531. doi: 10.1002/art.11353
Ostberg G. An arteritis with special reference to polymyalgia arteritica.Acta Pathol Microbiol Scand Suppl.1973; 237(Suppl):1–59
Ponte C, Grayson PC, Robson JC, et al.; DCVAS Study Group. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Ann Rheum Dis. 2022 Dec;81(12):1647-1653. doi: 10.1136/ard-2022-223480. Epub 2022 Nov 9. Erratum in: Ann Rheum Dis. 2023 Feb;82(2):e52. PMID: 36351706.
Hellmich B, Agueda A, Monti S, et al. 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Annals of the rheumatic diseases. 2020;79:19–30.
Maz M, Chung SA, Abril A, et al. 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis. Arthritis & rheumatology (Hoboken, NJ). 2021;73:1349–1365.
Chanouzas D, McGregor JAG, Nightingale P, et al. Intravenous pulse methylprednisolone for induction of remission in severe ANCA associated Vasculitis: a multi-center retrospective cohort study. BMC Nephrol. 2019;20:58.
Christ L, Scholtz G, Seitz L, et al. Tocilizumab Monotherapy after Ultra-Short Glucocorticoid Administration in Giant Cell Arteritis: a proof-of-concept trial. Lancet Rheumatology. 2021;In press.
Proven A, Gabriel SE, Orces C, et al.. Glucocorticoid therapy in giant cell arteritis: duration and adverse outcomes. Arthritis Rheum. 2003;49:703–8.
Mainbourg S, Addario A, Samson M, et al. Prevalence of Giant Cell Arteritis Relapse in Patients Treated With Glucocorticoids: A Meta-Analysis. Arthritis Care Res (Hoboken). 2020;72:838–849.
Alba MA, Garcia-Martinez A, Prieto-Gonzalez S, et al. Relapses in patients with giant cell arteritis: prevalence, characteristics, and associated clinical findings in a longitudinally followed cohort of 106 patients. Medicine (Baltimore). 2014;93:194–201.
Strehl C, Bijlsma JW, de Wit M, et al. Defining conditions where long-term glucocorticoid treatment has an acceptably low level of harm to facilitate implementation of existing recommendations: viewpoints from an EULAR task force. Annals of the rheumatic diseases. 2016;75:952–7.
Jover JA, Hernandez-Garcia C, Morado IC, et al.. Combined treatment of giant-cell arteritis with methotrexate and prednisone. a randomized, double-blind, placebo-controlled trial. Annals of internal medicine. 2001;134:106–14
Hoffman GS, Cid MC, Hellmann DB, et al. A multicenter, randomized, double-blind, placebo-controlled trial of adjuvant methotrexate treatment for giant cell arteritis. Arthritis and rheumatism. 2002;46:1309–18.
Spiera RF, Mitnick HJ, Kupersmith M, et al. A prospective, double-blind, randomized, placebo controlled trial of methotrexate in the treatment of giant cell arteritis (GCA). Clin Exp Rheumatol. 2001;19:495–501.
Mahr AD, Jover JA, Spiera RF, et al. Adjunctive methotrexate for treatment of giant cell arteritis: an individual patient data meta-analysis. Arthritis and rheumatism. 2007;56:2789–97.
Koster MJ, Yeruva K, Crowson CS, et al. Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study. The Journal of rheumatology. 2019;46:501–508.
Diamantopoulos AP, Hetland H and Myklebust G. Leflunomide as a corticosteroid-sparing agent in giant cell arteritis and polymyalgia rheumatica: a case series. Biomed Res Int. 2013;2013:120638.
Karabayas M, Dospinescu P, Fluck N, et al. Evaluation of adjunctive mycophenolate for large vessel giant cell arteritis. Rheumatol Adv Pract. 2020;4:rkaa069.
Ly KH, Dalmay F, Gondran G, et al. Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis: A single-center, retrospective study of 70 patients. Medicine (Baltimore). 2016;95:e4974.
Monti S, Águeda AF, Luqmani RA, et al. Systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis: focus on giant cell arteritis. RMD Open. 2019;5:e001003.
de Boysson H, Boutemy J, Creveuil C, et al. Is there a place for cyclophosphamide in the treatment of giant-cell arteritis? A case series and systematic review. Semin Arthritis Rheum. 2013;43:105–12.
Villiger PM, Adler S, Kuchen S, et al. Tocilizumab for induction and maintenance of remission in giant cell arteritis: a phase 2, randomised, double-blind, placebo-controlled trial. Lancet (London, England). 2016;387:1921–7.
Stone JH, Tuckwell K, Dimonaco S et al. Trial of Tocilizumab in Giant-Cell Arteritis. The New England journal of medicine. 2017;377:317–328.
Strand V, Dimonaco S, Tuckwell K, et al. Health-related quality of life in patients with giant cell arteritis treated with tocilizumab in a phase 3 randomised controlled trial. Arthritis Res Ther. 2019;21:64.
Corbera-Bellalta M, Alba-Rovira R, Muralidharan S, et al. Blocking GM-CSF receptor α with mavrilimumab reduces infiltrating cells, pro-inflammatory markers, and neoangiogenesis in ex-vivo cultured arteries from patients with giant cell arteritis. Annals of the rheumatic diseases. 2021.
Cid MC, Unizony S, Pupim L, et al. Mavrilimumab (anti GM-CSF receptor α monoclonal antibody) reduces risk of flare and increases sustained remission in a phase 2 trial of patients with giant cell arteritis. Annals of the rheumatic diseases. 2021;80:31.
NCT04474847. ClinicalTrials.gov. 2021.
Hernández-Rodríguez J, Segarra M, Vilardell C, et al. Tissue production of pro-inflammatory cytokines (IL-1beta, TNFalpha and IL-6) correlates with the intensity of the systemic inflammatory response and with corticosteroid requirements in giant-cell arteritis. Rheumatology (Oxford). 2004;43:294–301.
García-Martínez A, Hernández-Rodríguez J, Espígol-Frigolé G, et al. Clinical relevance of persistently elevated circulating cytokines (tumor necrosis factor alpha and interleukin-6) in the long-term followup of patients with giant cell arteritis. Arthritis Care Res (Hoboken). 2010;62:835–41.
Hoffman GS, Cid MC, Rendt-Zagar KE, et al. Infliximab for maintenance of glucocorticosteroid-induced remission of giant cell arteritis: a randomized trial. Annals of internal medicine. 2007;146:621–30.
Martínez-Taboada VM, Rodríguez-Valverde V, Carreño L, López et al. A double-blind placebo controlled trial of etanercept in patients with giant cell arteritis and corticosteroid side effects. Annals of the rheumatic diseases. 2008;67:625–30.
Seror R, Baron G, Hachulla E, et al. Adalimumab for steroid sparing in patients with giant-cell arteritis: results of a multicentre randomised controlled trial. Annals of the rheumatic diseases. 2014;73:2074–81.
NCT03725202. 2021.
Saadoun D, Lambert M, Mirault T, et al. Retrospective analysis of surgery versus endovascular intervention in Takayasu arteritis: a multicenter experience. Circulation. 2012;125:813–9.
Park HS, Do YS, Park KB, et al. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: angioplasty versus stent placement. Eur J Radiol. 2013;82:1913–8.
Jeong HS, Jung JH, Song GG, et al. Endovascular balloon angioplasty versus stenting in patients with Takayasu arteritis: A meta-analysis. Medicine (Baltimore). 2017;96:e7558.
NCT04366596. 2021.
Perera AH, Youngstein T, Gibbs RG, et al. Optimizing the outcome of vascular intervention for Takayasu arteritis. Br J Surg. 2014;101:43–50.
Assie C, Janvresse A, Plissonnier D, et al. Long-term follow-up of upper and lower extremity vasculitis related to giant cell arteritis: a series of 36 patients. Medicine (Baltimore). 2011;90:40–51.
Le Hello C, Auboire L, Berger L, et al. Symptomatic lower-limb giant-cell arteritis: Characteristics, management and long-term outcome. J Med Vasc. 2017;42:148–156.
Alba MA, Espígol-Frigolé G, Prieto-González S, et al. Central nervous system vasculitis: still more questions than answers. Curr Neuropharmacol. 2011;9:437–48
Guerrero AM, Sierra-Hidalgo F, Calleja P, et al. Intracranial internal carotid artery angioplasthy and stenting in giant cell arteritis. J Neuroimaging. 2015;25:307–309.
Uy CP, Tarkin JM, Gopalan D et al. The Impact of Integrated Noninvasive Imaging in the Management of Takayasu Arteritis. JACC Cardiovascular imaging. 2021;14:495–500.
Spira D, Xenitidis T, Henes J et al. MRI parametric monitoring of biological therapies in primary large vessel vasculitides: a pilot study. Br J Radiol. 2016;89:20150892.
Tombetti E, Godi C, Ambrosi A, et al. Novel Angiographic Scores for evaluation of Large Vessel Vasculitis. Sci Rep. 2018;8:15979
Nakagomi D, Cousins C, Sznajd J, et al. Development of a score for assessment of radiologic damage in large-vessel vasculitis (Combined Arteritis Damage Score, CARDS). Clin Exp Rheumatol. 2017;35 Suppl 103:139–145.
Prieto-González S, García-Martínez A, Tavera-Bahillo I, et al.. Effect of glucocorticoid treatment on computed tomography angiography detected large-vessel inflammation in giant-cell arteritis. A prospective, longitudinal study. Medicine (Baltimore). 2015;94:e486.
Einspieler I, Thurmel K, Pyka T, et al. Imaging large vessel vasculitis with fully integrated PET/MRI: a pilot study. European journal of nuclear medicine and molecular imaging. 2015;42:1012–24.
Martin O, Schaarschmidt BM, Kirchner J, et al. PET/MRI Versus PET/CT for Whole-Body Staging: Results from a Single-Center Observational Study on 1,003 Sequential Examinations. J Nucl Med. 2020;61:1131–1136.
Kermani TA, Warrington KJ, Crowson CS, et al. Large-vessel involvement in giant cell arteritis: a population-based cohort study of the incidence-trends and prognosis. Ann Rheum Dis 2013;72:1989–94, http://dx.doi.org/10.1136/annrheumdis-2012-202408.
de Boysson H, Liozon E, Espitia O, et al. Different patterns and specific outcomes of large-vessel involvements in giant cell arteritis. J Autoimmun 2019;103:102283, http://dx.doi.org/10.1016/j.jaut.2019.05.011.
Muratore F, Crescentini F, Spaggiari L, et al. Aortic dilatation in patients with large vessel vasculitis: A longitudinal case control study using PET/CT. Semin Arthritis Rheum 2019;48:1074–82, http://dx.doi.org/10.1016/j.semarthrit.2018.10.003
van der Geest KSM, Sandovici M, van Sleen Y, et al. Review: what is the current evidence for disease subsets in giant cell arteritis? Arthritis Rheumatol Hoboken NJ 2018;70:1366–76, http://dx.doi.org/10.1002/art.40520.
Referanslar
Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65:1–11.
Mahr A, Belhassen M, Paccalin M, et al. Characteristics and management of giant cell arteritis in France: a study based on nationa health insurance claims data. Rheumatol Oxf Engl 2020;59:120–8, http://dx.doi.org/10.1093/rheumatology/kez251.
Samson M, Corbera-Bellalta M, Audia S, et al. Recent advances in our understanding of giant cell arteritis pathogenesis. Autoimmun Rev 2017;16:833–44, http://dx.doi.org/10.1016/j.autrev.2017.05.014.
Horton BT, Magath TB and Brown GE. Arteritis of the temporal vessels: a previously undescribed form. Archives of internal medicine. 1934;53:400–409.
Kogstad OA. Polymyalgia rheumatica and its relation to arteritis temporalis. Acta Med Scand. 1965;178:591–8.
Gilmour JR. Giant cell chronic arteritis. J Pathol Bacteriol. 1941;53:263–277.
Hamrin B, Jonsson N and Hellsten S. Polymyalgia Arteritica. Annals of the rheumatic diseases. 1968;27:397–405.
Blockmans D, de Ceuninck L, Vanderschueren S, et al.. Repetitive 18F-fluorodeoxyglucose positron emission tomography in giant cell arteritis: a prospective study of 35 patients. Arthritis Rheum. 2006;55:131–7.
Schmidt WA, Natusch A, Moller DE, et al. Involvement of peripheral arteries in giant cell arteritis: a color Doppler sonography study. Clin Exp Rheumatol. 2002;20:309–18.
Hellmich B, Agueda A, Monti S et al. RA. 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Annals of the rheumatic diseases. 2020;79:19–30.
Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis.Arthritis Rheum.1990; 33:1122–1128. doi: 10.1002/art.1780330810CrossrefMedlineGoogle Scholar
Muratore F, Kermani TA, Crowson CS, et al. Large-vessel giant cell arteritis: a cohort study.Rheumatology (Oxford).2015; 54:463–470. doi: 10.1093/rheumatology/keu329CrossrefMedlineGoogle Scholar
de Boysson H, Daumas A, Vautier M, et al. Large-vessel involvement and aortic dilation in giant-cell arteritis. A multicenter study of 549 patients.Autoimmun Rev.2018; 17:391–398. doi: 10.1016/j.autrev.2017.11.029CrossrefMedlineGoogle Scholar
Vilaseca J, González A, Cid MC, et al. Clinical usefulness of temporal artery biopsy.Ann Rheum Dis.1987; 46:282–285. doi: 10.1136/ard.46.4.282CrossrefMedlineGoogle Scholar
Ponte C, Serafim AS, Monti S, et al. Early variation of ultrasound halo sign with treatment and relation with clinical features in patients with giant cell arteritis.Rheumatology (Oxford). 2020; 59:3717–3726. doi: 10.1093/rheumatology/keaa196CrossrefMedlineGoogle Scholar
Prieto-González S, Arguis P, García-Martínez A, et al. Large vessel involvement in biopsy-proven giant cell arteritis: prospective study in 40 newly diagnosed patients using CT angiography.Ann Rheum Dis.2012; 71:1170–1176. doi: 10.1136/annrheumdis-2011-200865CrossrefMedlineGoogle Scholar
Nuenninghoff DM, Hunder GG, Christianson TJ, et al. Incidence and predictors of large-artery complication (aortic aneurysm, aortic dissection, and/or large-artery stenosis) in patients with giant cell arteritis: a population-based study over 50 years.Arthritis Rheum.2003; 48:3522–3531. doi: 10.1002/art.11353
Ostberg G. An arteritis with special reference to polymyalgia arteritica.Acta Pathol Microbiol Scand Suppl.1973; 237(Suppl):1–59
Ponte C, Grayson PC, Robson JC, et al.; DCVAS Study Group. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Ann Rheum Dis. 2022 Dec;81(12):1647-1653. doi: 10.1136/ard-2022-223480. Epub 2022 Nov 9. Erratum in: Ann Rheum Dis. 2023 Feb;82(2):e52. PMID: 36351706.
Hellmich B, Agueda A, Monti S, et al. 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Annals of the rheumatic diseases. 2020;79:19–30.
Maz M, Chung SA, Abril A, et al. 2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis. Arthritis & rheumatology (Hoboken, NJ). 2021;73:1349–1365.
Chanouzas D, McGregor JAG, Nightingale P, et al. Intravenous pulse methylprednisolone for induction of remission in severe ANCA associated Vasculitis: a multi-center retrospective cohort study. BMC Nephrol. 2019;20:58.
Christ L, Scholtz G, Seitz L, et al. Tocilizumab Monotherapy after Ultra-Short Glucocorticoid Administration in Giant Cell Arteritis: a proof-of-concept trial. Lancet Rheumatology. 2021;In press.
Proven A, Gabriel SE, Orces C, et al.. Glucocorticoid therapy in giant cell arteritis: duration and adverse outcomes. Arthritis Rheum. 2003;49:703–8.
Mainbourg S, Addario A, Samson M, et al. Prevalence of Giant Cell Arteritis Relapse in Patients Treated With Glucocorticoids: A Meta-Analysis. Arthritis Care Res (Hoboken). 2020;72:838–849.
Alba MA, Garcia-Martinez A, Prieto-Gonzalez S, et al. Relapses in patients with giant cell arteritis: prevalence, characteristics, and associated clinical findings in a longitudinally followed cohort of 106 patients. Medicine (Baltimore). 2014;93:194–201.
Strehl C, Bijlsma JW, de Wit M, et al. Defining conditions where long-term glucocorticoid treatment has an acceptably low level of harm to facilitate implementation of existing recommendations: viewpoints from an EULAR task force. Annals of the rheumatic diseases. 2016;75:952–7.
Jover JA, Hernandez-Garcia C, Morado IC, et al.. Combined treatment of giant-cell arteritis with methotrexate and prednisone. a randomized, double-blind, placebo-controlled trial. Annals of internal medicine. 2001;134:106–14
Hoffman GS, Cid MC, Hellmann DB, et al. A multicenter, randomized, double-blind, placebo-controlled trial of adjuvant methotrexate treatment for giant cell arteritis. Arthritis and rheumatism. 2002;46:1309–18.
Spiera RF, Mitnick HJ, Kupersmith M, et al. A prospective, double-blind, randomized, placebo controlled trial of methotrexate in the treatment of giant cell arteritis (GCA). Clin Exp Rheumatol. 2001;19:495–501.
Mahr AD, Jover JA, Spiera RF, et al. Adjunctive methotrexate for treatment of giant cell arteritis: an individual patient data meta-analysis. Arthritis and rheumatism. 2007;56:2789–97.
Koster MJ, Yeruva K, Crowson CS, et al. Efficacy of Methotrexate in Real-world Management of Giant Cell Arteritis: A Case-control Study. The Journal of rheumatology. 2019;46:501–508.
Diamantopoulos AP, Hetland H and Myklebust G. Leflunomide as a corticosteroid-sparing agent in giant cell arteritis and polymyalgia rheumatica: a case series. Biomed Res Int. 2013;2013:120638.
Karabayas M, Dospinescu P, Fluck N, et al. Evaluation of adjunctive mycophenolate for large vessel giant cell arteritis. Rheumatol Adv Pract. 2020;4:rkaa069.
Ly KH, Dalmay F, Gondran G, et al. Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis: A single-center, retrospective study of 70 patients. Medicine (Baltimore). 2016;95:e4974.
Monti S, Águeda AF, Luqmani RA, et al. Systematic literature review informing the 2018 update of the EULAR recommendation for the management of large vessel vasculitis: focus on giant cell arteritis. RMD Open. 2019;5:e001003.
de Boysson H, Boutemy J, Creveuil C, et al. Is there a place for cyclophosphamide in the treatment of giant-cell arteritis? A case series and systematic review. Semin Arthritis Rheum. 2013;43:105–12.
Villiger PM, Adler S, Kuchen S, et al. Tocilizumab for induction and maintenance of remission in giant cell arteritis: a phase 2, randomised, double-blind, placebo-controlled trial. Lancet (London, England). 2016;387:1921–7.
Stone JH, Tuckwell K, Dimonaco S et al. Trial of Tocilizumab in Giant-Cell Arteritis. The New England journal of medicine. 2017;377:317–328.
Strand V, Dimonaco S, Tuckwell K, et al. Health-related quality of life in patients with giant cell arteritis treated with tocilizumab in a phase 3 randomised controlled trial. Arthritis Res Ther. 2019;21:64.
Corbera-Bellalta M, Alba-Rovira R, Muralidharan S, et al. Blocking GM-CSF receptor α with mavrilimumab reduces infiltrating cells, pro-inflammatory markers, and neoangiogenesis in ex-vivo cultured arteries from patients with giant cell arteritis. Annals of the rheumatic diseases. 2021.
Cid MC, Unizony S, Pupim L, et al. Mavrilimumab (anti GM-CSF receptor α monoclonal antibody) reduces risk of flare and increases sustained remission in a phase 2 trial of patients with giant cell arteritis. Annals of the rheumatic diseases. 2021;80:31.
NCT04474847. ClinicalTrials.gov. 2021.
Hernández-Rodríguez J, Segarra M, Vilardell C, et al. Tissue production of pro-inflammatory cytokines (IL-1beta, TNFalpha and IL-6) correlates with the intensity of the systemic inflammatory response and with corticosteroid requirements in giant-cell arteritis. Rheumatology (Oxford). 2004;43:294–301.
García-Martínez A, Hernández-Rodríguez J, Espígol-Frigolé G, et al. Clinical relevance of persistently elevated circulating cytokines (tumor necrosis factor alpha and interleukin-6) in the long-term followup of patients with giant cell arteritis. Arthritis Care Res (Hoboken). 2010;62:835–41.
Hoffman GS, Cid MC, Rendt-Zagar KE, et al. Infliximab for maintenance of glucocorticosteroid-induced remission of giant cell arteritis: a randomized trial. Annals of internal medicine. 2007;146:621–30.
Martínez-Taboada VM, Rodríguez-Valverde V, Carreño L, López et al. A double-blind placebo controlled trial of etanercept in patients with giant cell arteritis and corticosteroid side effects. Annals of the rheumatic diseases. 2008;67:625–30.
Seror R, Baron G, Hachulla E, et al. Adalimumab for steroid sparing in patients with giant-cell arteritis: results of a multicentre randomised controlled trial. Annals of the rheumatic diseases. 2014;73:2074–81.
NCT03725202. 2021.
Saadoun D, Lambert M, Mirault T, et al. Retrospective analysis of surgery versus endovascular intervention in Takayasu arteritis: a multicenter experience. Circulation. 2012;125:813–9.
Park HS, Do YS, Park KB, et al. Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: angioplasty versus stent placement. Eur J Radiol. 2013;82:1913–8.
Jeong HS, Jung JH, Song GG, et al. Endovascular balloon angioplasty versus stenting in patients with Takayasu arteritis: A meta-analysis. Medicine (Baltimore). 2017;96:e7558.
NCT04366596. 2021.
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