Evaluation of adjunctive mycophenolate for large vessel giant cell arteritis

Karabayas, Maira; Dospinescu, Paula; Fluck, Nick; Kidder, Dana; Fordyce, Gillian; Hollick, Rosemary J; Bari, Cosimo De; Basu, Neil

doi:10.1093/rap/rkaa069

Cited by 13 publications

(10 citation statements)

References 19 publications

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“…However, the AE profile of cyclophosphamide in this setting advises against its use as a GC-sparing therapy. In a retrospective cohort study conducted in 37 patients (65% female) with LVV-GCA prescribing mycophenolate derivatives (mycophenolate mofetil or mycophenolic acid) at diagnosis and followed up for ≥2 years, relapse rates at 1 and 2 years were 16.2 and 27%, respectively, and CRP levels at 1 and 2 years were both 4 (interquartile range: 4–4) mg/L [ 56 ].…”

Section: Treatment Of Giant Cell Arteritismentioning

confidence: 99%

Advances in the Treatment of Giant Cell Arteritis

Castañeda

Prieto-Peña

Vicente-Rabaneda

et al. 2022

JCM

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Giant cell arteritis (GCA) is the most common vasculitis among elderly people. The clinical spectrum of the disease is heterogeneous, with a classic/cranial phenotype, and another extracranial or large vessel phenotype as the two more characteristic patterns. Permanent visual loss is the main short-term complication. Glucocorticoids (GC) remain the cornerstone of treatment. However, the percentage of relapses with GC alone is high, and the rate of adverse events affects more than 80% of patients, so it is necessary to have alternative therapeutic options, especially in patients with worse prognostic factors or high comorbidity. MTX is the only DMARD that has shown to reduce the cumulative dose of GC, while tocilizumab is the first biologic agent approved due to its ability to decrease the relapse rate and lower the cumulative GC doses. However, apart from the IL-6 pathway, there are other pro-inflammatory cytokines and growth factors involved in the typical intima hyperplasia and vascular remodeling of GCA. Among them, the more promising targets in GCA treatment are the IL12/IL23 axis antagonists, IL17 inhibitors, modulators of T lymphocytes, and inhibitors of either the JAK/STAT pathway, the granulocyte-macrophage colony-stimulating factor, or the endothelin, all of which are updated in this review.

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Section: Treatment Of Giant Cell Arteritismentioning

confidence: 99%

Advances in the Treatment of Giant Cell Arteritis

Castañeda

Prieto-Peña

Vicente-Rabaneda

et al. 2022

JCM

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“…Karabayaset al 52 assessed the use of MMF for large-vessel GCA (LV-GCA). 52 The study found that MMF in conjunction with corticosteroids was well tolerated and reduced the length of corticosteroid exposure. MMF has also been evaluated for treatment in TKA.…”

Section: Treatmentmentioning

confidence: 99%

Large-Vessel Vasculitis in Ophthalmology: Giant Cell Arteritis and Takayasu Arteritis

Dhanani

Zhao

Charoenkijkajorn

et al. 2022

Asia-Pacific Journal of Ophthalmology

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Giant cell arteritis and Takayasu arteritis are large-vessel vasculitides that share multiple common features but also have significant differences in epidemiology, demographics, clinical presentation, evaluation, and treatment. Giant cell arteritis is more common in elderly patients of Caucasian descent versus Takayasu arteritis, which is more prevalent in younger patients of Asian descent. Although traditionally age has been the main criterion for differentiating the 2 etiologies, modifications in the diagnostic criteria have recognized the overlap between the 2 conditions. In this monograph, we review the diagnostic criteria for both conditions and describe the epidemiology, pathogenesis, histology, evaluation, and management for large-vessel vasculitis in ophthalmology. Additionally, we describe ocular imaging techniques that may be utilized by ophthalmologists to identify manifestations of large-vessel vasculiti- des in patients. Lastly, we compare and contrast the key clinical, laboratory, and pathologic features that might help ophthalmologists to differentiate the 2 entities.

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“…Las recaídas al primer y segundo año fueron del 16,2% y 27% respectivamente. A los 2 años de tratamiento, 31 pacientes continuaron con adecuada tolerancia al MMF 36 . Con muy bajo nivel de evidencia, no se recomienda el uso de MMF en el tratamiento de la ACG.…”

Section: En Acg De Reciente Diagnóstico No Se Recomienda El Tratamien...unclassified

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2022

Rev. Argent. Reumatol.

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Palabras clave: arteritis de células gigantes; vasculitis; tratamiento; recomendación RESUMEN La arteritis de células gigantes (ACG) es una vasculitis sistémica que afecta a personas adultas; compromete vasos arteriales de mediano y gran calibre, con potenciales complicaciones de gravedad, como la ceguera, y es considerada una emergencia médica. El objetivo de estas guías fue desarrollar las primeras recomendaciones argentinas para su tratamiento, basadas en la revisión de la literatura mediante metodología GRADE. Un panel de expertos en vasculitis elaboró las preguntas en formato PICO (población, intervención, comparador y outcomes), y luego un panel de expertos en metodología efectuó la revisión de la bibliografía con la extracción de la evidencia para cada una de las preguntas. Se realizó un focus group de pacientes para conocer sus preferencias y experiencias. Finalmente, con la información recabada, el panel de expertos en vasculitis procedió a la votación de las recomendaciones que a continuación se presentan.

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Evaluation of adjunctive mycophenolate for large vessel giant cell arteritis

Cited by 13 publications

References 19 publications

Advances in the Treatment of Giant Cell Arteritis

Advances in the Treatment of Giant Cell Arteritis

Large-Vessel Vasculitis in Ophthalmology: Giant Cell Arteritis and Takayasu Arteritis

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