Giant cell arteritis
- Arteritis cranialis
- Arteritis temporalis
- Cranial arteritis
- Horton disease
Your QuestionAre there alternate therapies to prednisone?
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The treatment of choice for giant cell arteritis is corticosteroid medication, usually prednisone. This condition is typically treated with high doses of this medication. If not treated promptly, the condition carries a small but definite risk of blindness, so prednisone should be started as soon as possible, perhaps even before confirmation is made through a temporal artery biopsy.
Most people begin to feel better within a few days after starting treatment. However, the medication needs to be continued for 1 - 2 years, over which time the dose is slowly reduced. Taking corticosteroid medications for this long can make bones thinner and increase the chance of a fracture. As a result, individuals undergoing treatment should avoid smoking and alcohol consumption, take extra calcium and vitamin D, start walking or doing other weight-bearing exercises, and have periodic bone mineral density testing.
Other medications that suppress the immune system are sometimes also needed.
While corticosteroids remain the treatment of choice, due to their potential side-effects, other therapies have been considered. Anti-tumor necrosis factor (TNF) therapy (infliximab and etanercept) has been utilized in some patients with longstanding corticosteroid-resistant temporal arteritis who are at risk for adverse events. Other possible therapies include cyclophosphamide, cyclosporine, dapsone, tocilizumab, rituximab, and abatacept, though none of these is routinely recommended.
- Polymyalgia Rheumatica and Giant Cell Arteritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). July 2011; http://www.niams.nih.gov/Health_Info/Polymyalgia/default.asp. Accessed 9/19/2011.
- Bhimji S. Temporal arteritis. MedlinePlus. 2011; http://www.nlm.nih.gov/medlineplus/ency/article/000448.htm. Accessed 9/19/2011.
- Albertini JG, Marks VJ, Cronin H. Temporal (Giant Cell) Arteritis Medication. eMedicine. 2009; http://emedicine.medscape.com/article/1084911-medication#showall. Accessed 9/19/2011.