Giant Cell Arteritis & IL6

Although histological proof of GCA is the gold standard, temporal artery biopsy is seldom done these days because:
1) the biopsied segment may not contain the pathology (skip lesions, sampling error), as this study demonstrates;
2) we have non-invasive diagnostic tools like ultrasound, CT angiogram and PET scan with good sensitivity and specificity, some of which being able to delineate extent of vessels involved;
3) patients don’t like surgical procedures if they can help it, especially if complications can happen, though uncommon (skin necrosis, scarring, haematoma, etc).
This study suggests 4 predictors of the diagnosis:
1) persistent headaches;
2) jaw claudication (ache with chewing);
3) elevated platelet count;
4) elevated ESR.
These will not eliminate the need for imaging, but rather steer the diagnostic workup towards imaging.

Tocilizumab Induces and Maintains Remission in Giant Cell Arteritis

Lancet has reported the results of a randomized, double-blind, placebo-controlled trial of tocilizumab in patients with new-onset giant cell arteritis (GCA). Thirty…

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