Management overview for giant cell arteritis

For a management approach common to most of the systemic vasculitides, including the principles of inducing and maintaining remission of disease, see Management overview for systemic vasculitides.

Giant cell arteritis (GCA) requires specialist management and is treated with a long course of high-dose systemic corticosteroids.

Note: If giant cell arteritis is suspected, discuss urgently with a specialist to determine if immediate treatment is required.

If giant cell arteritis is suspected, discuss urgently with a specialist to determine if immediate intensive induction therapy is required. Rheumatologists strongly encourage direct contact by general practitioners to expedite referral or obtain advice on treatment (eg before starting high-dose oral corticosteroids). A delay in treatment can result in serious consequences such as blindness or ischaemic events.

If giant cell arteritis is strongly suspected, ideally discuss with a specialist and start pre-emptive treatment immediately, without waiting for investigations to be performed (eg temporal artery biopsy, specialised vascular imaging). The same is true for any patient with polymyalgia rheumatica (PMR), or a history of PMR, who develops classic symptoms of giant cell arteritis.

Note: Start pre-emptive treatment immediately for suspected giant cell arteritis, without waiting for investigations to be performed.