Which immunosuppressant agents may be used in the treatment of giant cell arteritis (GCA) (temporal arteritis)?

Updated: Sep 03, 2020
  • Author: Mythili Seetharaman, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Interleukin-6 (IL-6) plays a role in the inflammation of GCA (see Pathophysiology). In phase 2 studies, treatment of GCA with the IL-6 receptor blocker tocilizumab resulted in faster achievement of remission, with significant reduction in corticosteroid doses, and prolonged maintenance of remission. [148, 149] In May 2017, the US Food and Drug Administration (FDA) expanded the indications for use of tocilizumab for use in GCA. Tocilizumab had previously been approved for use in rheumatoid arthritis. [150]

Alternative immunosuppressant agents (eg, cyclosporine, azathioprine, methotrexate) may be started later in the course of treatment. They can be useful as steroid-sparing agents in patients who require prolonged treatment with high doses of steroids (more than 5-10 mg/d) and those who experience significant steroid-related complications.


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