Treatments and drugsBy Mayo Clinic Staff
Treatment for giant cell arteritis consists of high doses of a corticosteroid drug such as prednisone. Because immediate treatment is necessary to prevent vision loss, your doctor is likely to start medication even before confirming the diagnosis with a biopsy.
You'll likely begin to feel better within just a few days of beginning treatment. Unless you have complete vision loss, your visual symptoms will likely clear up within three months.
You may need to continue taking medication for one to two years or longer. After the first month, your doctor may gradually begin to lower the dosage until you reach the lowest dose of corticosteroids needed to control inflammation.
Some symptoms, particularly headache, may return during this tapering period. This is also the point at which many people also develop symptoms of polymyalgia rheumatica. Such flares can usually be treated with slight increases in the corticosteroid dose. Your doctor may also suggest a drug called methotrexate, which may help reduce the side effects of corticosteroids.
Corticosteroids can lead to a number of serious side effects, such as osteoporosis, high blood pressure and muscle weakness. To counter these potential side effects, your doctor is likely to monitor your bone density and may prescribe calcium and vitamin D supplements or other medications to help prevent bone loss. Your doctor is also likely to monitor your blood pressure and may recommend an exercise program, diet changes and medication to keep blood pressure within a normal range. Most side effects go away when the corticosteroid treatment is tapered and stopped.
Oct. 02, 2015
- Borchers AT, et al. Giant cell arteritis: A review of classification, pathophysiology, geoepidemiology and treatment. Autoimmunity Reviews. 2012;11:A544.
- Giant cell arteritis. American College of Rheumatology. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Giant-Cell-Arteritis. Accessed Aug. 24, 2015.
- Mukhtyar C, et al. EULAR recommendations for the management of large vessel vasculitis. Annals of Rheumatic Diseases. 2009;68:318. http://ard.bmj.com. Accessed Aug. 24, 2015.
- Unizony S, et al. Inpatient complications in patients with giant cell arteritis: Decreased mortality and increased risk of thromboembolism, delirium and adrenal insufficiency. Rheumatology. 2015;54:1360.
- Weyand CM, et al. Giant-cell arteritis and polymyalgia rheumatica. New England Journal of Medicine. 2014;371:50.
- Smith JH, et al. Giant cell arteritis. Headache. 2014;54:1273.
- Polymyalgia rheumatica and giant cell arteritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Polymyalgia/default.asp. Accessed Aug. 24, 2015.
- Kermani TA, et al. Disease relapses among patients with giant cell arteritis: A prospective, longitudinal cohort study. Journal of Rheumatology. 2015;42:7.
- Singh AG, et al. Visual manifestations in giant cell arteritis: Trend over 5 decades in a population-based cohort. Journal of Rheumatology. 2015;42:2.
- Osteoporosis: Handout on health. NIH Osteoporosis and Related Bone Diseases National Resource Center. http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/osteoporosis_hoh.asp. Accessed Aug. 25, 2015.
- Mollan SP, et al. Aspirin as adjunctive treatment for giant cell arteritis. Cochrane Database of Systematic Reviews. http://ovidsp.tx.ovid.com/sp-3.16.Ob/ovidweb.cgi. Accessed Aug. 25, 2015.
- Chang-Miller A (expert opinion). Mayo Clinic, Scottsdale, Ariz. Sept. 3, 2015.