Giant cell arteritis: Update on clinical manifestations, diagnosis, and management

Giant cell arteritis (GCA) is the most common vasculitis affecting people older than 50 years. The last decades have shed new light on the clinical paradigm of this condition, expanding its spectrum beyond cranial vessel inflammation. GCA can be now considered a multifaceted vasculitic syndrome encompassing inflammation of cranial and extra-cranial arteries and girdles, isolated or combined. Such heterogeneity often leads to diagnostic delays and increases the likelihood of acute and chronic GCA-related damage. On the other hand, the approach to suspected GCA patients has been revolutionized by the introduction of vascular ultrasound which allows a rapid, cost-effective, and non-invasive GCA diagnosis. Likewise, the use of tocilizumab is now part of the therapeutic algorithm of GCA and ensures a satisfactory disease control even in steroid-refractory patients. Nonetheless, some aspects of GCA still need to be clarified, including the clinical correlation of different histological patterns, and the prevention of long-term vascular complications.This narrative review depicts the diagnostic and therapeutic aspects of GCA most relevant in clinical practice, with a focus on clinical updates and novelties introduced over the last decade.

Automated summary

Giant cell arteritis (GCA) is a common vasculitis that primarily affects individuals over 50 years old. Recent research has expanded our understanding of this condition, revealing that it can involve inflammation in both cranial and extra-cranial arteries. The introduction of vascular ultrasound has revolutionized the diagnosis of suspected GCA, offering a rapid, cost-effective, and non-invasive method. Tocilizumab has also become an important part of the treatment algorithm for GCA, providing effective disease control even in patients who are resistant to steroids.