Giant Cell Arteritis and Polymyalgia Rheumatica : Treatment Approaches and New Targets - 16/06/23

Doi : 10.1016/j.rdc.2023.03.005

Desh Nepal, MD ^a,^⁎ , Michael Putman, MD, MS ^a, Sebastian Unizony, MD ^b
^a Department of Medicine, Division of Rheumatology, Hub for Collaborative Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Rheumatology, 6th Floor, Milwaukee, WI 53226, USA
^b Massachusetts General Hospital, Vasculitis and Glomerulonephritis Center, Harvard Medical School, 55 Fruit Street, Yawkey 4B, Boston, MA 02114, USA

^∗Corresponding author.

Résumé

Prolonged glucocorticoid tapers have been the standard of care for giant cell arteritis (GCA) and polymyalgia rheumatica (PMR), but recent advancements have improved outcomes for patients with GCA while reducing glucocorticoid-related toxicities. Many patients with GCA and PMR still experience persistent or relapsing disease, and cumulative exposure to glucocorticoids for both diseases remains high. The objective of this review is to define current treatment approaches as well as new therapeutic targets and strategies. Studies investigating inhibition of cytokine pathways, including interleukin-6, interleukin-17, interleukin-23, granulocyte-macrophage colony-stimulating factor, Janus kinase–signal transduction and activator of transcription, and others, will be reviewed.

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Keywords : Giant cell arteritis, Polymyalgia rheumatica, Tocilizumab, Glucocorticoids, Mavrilimumab, Secukinumab, Abatacept, Guselkumab