European Headache Federation recommendations for neurologists managing giant cell arteritis

The Journal of Headache and Pain

S. P. Mollan¹  K. Paemeleire²  J. Versijpt³  A. J. Sinclair⁴  R. Luqmani⁵ 

[1] Birmingham Neuro-Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital;Department of Neurology, Ghent University Hospital;Department of Neurology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel);Metabolic Neurology, Institute of Metabolism and Systems Research, University of Birmingham;The Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kennedy Institute of Rheumatology;

关键词: Giant cell arteritis;    Temporal arteritis;    Headache;    Large vessel Vasculitis;    Polymyalgia Rheumatica;    Tocilizumab;   

DOI  :  10.1186/s10194-020-01093-7

来源: DOAJ

【 摘 要 】

Abstract Background and aim Giant cell arteritis (GCA) remains a medical emergency because of the risk of sudden irreversible sight loss and rarely stroke along with other complications. Because headache is one of the cardinal symptoms of cranial GCA, neurologists need to be up to date with the advances in investigation and management of this condition. The aim of this document by the European Headache Federation (EHF) is to provide an evidence-based and expert-based recommendations on GCA. Methods The working group identified relevant questions, performed systematic literature review and assessed the quality of available evidence, and wrote recommendations. Where there was not a high level of evidence, the multidisciplinary (neurology, ophthalmology and rheumatology) group recommended best practice based on their clinical experience. Results Across Europe, fast track pathways and the utility of advanced imaging techniques are helping to reduce diagnostic delay and uncertainty, with improved clinical outcomes for patients. GCA is treated with high dose glucocorticoids (GC) as a first line agent however long-term GC toxicity is one of the key concerns for clinicians and patients. The first phase 2 and phase 3 randomised controlled trials of Tocilizumab, an IL-6 receptor antagonist, have been published. It is now been approved as the first ever licensed drug to be used in GCA. Conclusion The present article will outline recent advances made in the diagnosis and management of GCA.

【 授权许可】

Unknown