British Society for Rheumatology Guideline on Diagnosis and Treatment of Giant Cell Arteritis: Executive Summary

Sarah L. Mackie; Christian Dejaco; Simone Appenzeller; Dario Camellino; Christina Duftner; Solange Gonzalez-Chiappe; Alfred Mahr; Chetan Mukhtyar; Gary Reynolds; Alexandre Wagner S. de Souza; Elisabeth Brouwer; Marwan Bukhari; Frank Buttgereit; Dorothy Byrne; Maria C. Cid; Marco Cimmino; Haner Direskeneli; Kate Gilbert; Tanaz A. Kermani; Asad Khan; Peter Lanyon; Raashid Luqmani; Christian Mallen; Justin C. Mason; Eric L. Matteson; Peter A. Merkel; Susan Mollan; Lorna Neill; Eoin O' Sullivan; Maria Sandovici; Wolfgang A. Schmidt; Richard Watts; Madeline Whitlock; Elaine Yacyshyn; Steven Ytterberg; Bhaskar Dasgupta


Rheumatology. 2020;59(3):487-494. 

In This Article

Abstract and Introduction


GCA, or temporal arteritis, is a large-vessel vasculitis affecting older people.[1] Without high-dose glucocorticoid treatment, GCA can lead to occlusion of cranial blood vessels, which may result in blindness or stroke.[2] Most occurrences of blindness or stroke happen either before treatment or during the first week of treatment.[3] GCA is therefore a medical emergency requiring immediate treatment. Many patients with GCA have inflammation of the aorta and its proximal branches (extracranial large-vessel involvement), which can lead to aortic aneurysm, dissection or rupture.[4] Recent years have seen new evidence emerge regarding the diagnosis and treatment of GCA, requiring a major update of the 2010 British Society for Rheumatology (BSR) guideline.[5]

Objectives: To provide guidance for clinicians in the diagnosis and treatment of GCA, supported by evidence where possible.

Target audience: This guideline is intended for doctors and allied health professionals who work in a primary or secondary care setting and manage patients with suspected and/or established GCA.

Areas not covered: Takayasu arteritis,[6] isolated PMR[7,8] and management of glucocorticoid-related complications such as osteoporosis.[9]

For details concerning each section please refer to the full guideline published online.

This guideline was developed using Grading of Recommendations, Assessment, Development and Evaluations (GRADE) to produce evidence-based recommendations.[10]