Steroid-Sparing Agents in Giant Cell Arteritis

Sagdeo, Amol; Askari, Ayman; Dixey, Josh; Morrissey, Hana; Ball, Patrick A.

Steroid-Sparing Agents in Giant Cell Arteritis

Amol Sagdeo¹, Ayman Askari¹, Josh Dixey¹, Hana Morrissey^{2, *}, Patrick A. Ball²

¹ The Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, SY10 7AG, UK

² University of Wolverhampton, School of Pharmacy, WV1 1LY, UK

Article Information

Identifiers and Pagination:

Year: 2019
Volume: 13
First Page: 61
Last Page: 71
Publisher ID: TORJ-13-61
DOI: 10.2174/1874312901913010061

Article History:

Received Date: 17/04/2019
Revision Received Date: 12/06/2019
Acceptance Date: 08/07/2019
Electronic publication date: 31/07/2019
Collection year: 2019

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© 2019 Sagdeo et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

^* Address correspondence to this author at the University of Wolverhampton, School of Pharmacy, WV1 1LY, UK; Email: hana.morrissey@wlv.ac.uk; ORCID: https://orcid.org/0000-0001-9752-537X

Background:

Giant cell arteritis is the commonest form of medium-to-large vessel vasculitis, requiring long-term corticosteroid therapy. The short- and long-term side effects of corticosteroids are many, including weight gain, psychological effects, osteoporosis, cardiometabolic complications, and infections.

Materials and Methods:

Various agents used in place of or in combination with corticosteroids to reduce corticosteroid-related side effects were reviewed. However, considerable variation in practice was identified giving unclear guidance. This review included the most recent evidence on methotrexate, mycophenolate mofetil, azathioprine, cyclophosphamide, abatacept, and tocilizumab

Results and Discussion:

Also discussed are encouraging results with tocilizumab in GCA patients. Amongst the agents available for steroid-sparing effects, tocilizumab demonstrated the most robust data and is consequently recommended as the agent of choice for steroid-sparing, for remission induction, remission maintenance, and treating relapsing and refractory cases of GCA.

Keyword: Corticosteroids, Tocilizumab, Giant cell arteritis, Vasculitis, Steroid-sparing, EULAR, Epidemiology.

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RESEARCH ARTICLE

Steroid-Sparing Agents in Giant Cell Arteritis

Article Information

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Article History:

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Abstract

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