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Spotlight on Temporal arteritis

Temporal arteritis is an important cause of ischemic complications in elderly patients, and timely diagnosis can prevent important morbidity, most notably blindness from either anterior ischemic optic neuropathy or central retinal artery occlusion. These patients, left untreated, are also at increased risk for ischemic stroke. Treatment with high-dose corticosteroids is effective in preventing these complications, and initial treatment with intravenous pulse corticosteroids leads to more sustained clinical remission and lower subsequent oral corticosteroid dosage requirement. Other adjunctive immunosuppressant drugs are also currently being used in this setting as steroid-sparing agents.

In this article, Dr. Peter MacIntosh and Dr. Omar Solyman of the University of Illinois at Chicago cite studies showing increased risk for a variety of ischemic cardiovascular complications among patients with temporal arteritis and patients who were taking statin drugs, which had a somewhat lesser incidence of these complications. They also review advances in biological treatment of giant cell arteritis with monoclonal antibodies with and without concomitant corticosteroid treatment.

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