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Self-Assessment Questions

Rheumatology


Answer 3
  1. Prednisone 60 mg/day and aspirin 81 mg/day. Corticosteroids are the only proven treatment for GCA. They should be started at 60 mg/day for the first few weeks and then tapered. Treatment often lasts many years, and relapses are common once corticosteroids are stopped. The addition of an antiplatelet agent, such as aspirin, can reduce the odds of cerebral ischemic events and visual loss.2,3 The addition of aspirin should be considered in light of the patient’s medication history and in conjunction with gastrointestinal prophylaxis, especially in the elderly. Although useful as steroid-sparing agents for many other conditions, methotrexate and infliximab are not useful in the treatment of GCA.

    REFERENCES
    2. Lee MS, Smith SD, Galor A, Hoffman GS. Antiplatelet and anticoagulant therapy in patients with giant cell arteritis. Arthritis Rheum 2006;54:3306-9.

    3. Nesher G, Berkun Y, Mates M, et al. Low-dose aspirin and prevention of cranial ischemic complications in giant cell arteritis. Arthritis Rheum 2004;50:1332-7.

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