Follow-up for people with giant cell arteritis

People with giant cell arteritis (GCA) should be reviewed by their specialist intermittently, while their therapy is being withdrawn, to monitor for disease relapse. The frequency of follow-up is tailored to individual circumstances, including disease phenotype, treatment used, and risk factors for complications from the disease or its treatment.

Check inflammatory markers (erythrocyte sedimentation rate [ESR] and serum C-reactive protein [CRP] concentration) monthly for the first 3 months of therapy, then every 2 to 3 months or as clinically indicated. It is important to note that tocilizumab supresses inflammatory markers, so the markers are not useful for monitoring disease activity.

Giant cell arteritis is the only systemic vasculitis in which it is possible to stop long-term oral corticosteroids. Most people can stop treatment completely in 2 to 4 years. Tapering long-term, high-dose corticosteroids can be problematic and must be done under specialist instruction. Continuous follow-up is probably not needed, but people should seek urgent assistance from their general practitioner or specialist if their symptoms relapse.