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Giant cell arteritis - (GCA)

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Treatment for GCA consists of high doses — usually 40 to 60 milligrams (mg) — of a corticosteroid drug such as prednisone. Because immediate treatment is necessary to prevent vision loss, your doctor is likely to start medication even before confirming the diagnosis with a biopsy.

You should start feeling better in just a few days, but you may need to continue taking medication for two years or longer. After the first month, your doctor may gradually begin to lower the dosage until you reach the lowest dose of corticosteroids needed to control inflammation as measured by sed rate and CRP tests. Some of your symptoms may return during this tapering period.

What are corticosterioids?
Corticosteroids are powerful anti-inflammatory drugs whose effects mimic those of hormones produced by your adrenal glands. The drugs can effectively relieve pain, but prolonged use — especially at high doses — can lead to a number of serious side effects.

Older adults, who are most likely to be treated for giant cell arteritis, are particularly at risk because they're more prone to certain conditions that also may be caused by corticosteroids. These include:

Other possible side effects of cortisone therapy include:

  • Weight gain

  • Increased blood sugar levels, sometimes leading to diabetes

  • Thinning skin and increased bruising

  • Decreased immune system function

  • Mood changes

New treatments
Researchers are trying to find therapies that work as well as corticosteroids but cause fewer side effects. One drug under investigation is methotrexate, which doctors often use to treat certain cancers and some inflammatory conditions such as rheumatoid arthritis. Other studies have used both methotrexate and prednisone to treat people with GCA. Preliminary results show that lower doses of prednisone are possible when the two drugs are combined.

Coping skills

When giant cell arteritis is caught and treated early, the prognosis is usually excellent. Your symptoms should improve within just a few hours or days of beginning corticosteroid treatment, and your vision isn't likely to be affected. Your greatest challenge in this case may be coping with any side effects of your medication. The following suggestions may help:

  • Understand your condition. Learn everything you can about giant cell arteritis and its treatment. In addition to talking to your doctor, you may want to check reliable Web sites, such as the National Heart, Lung and Blood Institute and the Arthritis Foundation. Know the possible side effects of any medication you take, and report any changes in your health to your doctor.

  • Eat a healthy diet. Eating well can help prevent potential problems such as thinning bones, high blood pressure and diabetes. Emphasize fresh fruits and vegetables, whole grains, and lean meats and fish, while limiting salt, sugar and alcohol. Be sure to get adequate amounts of calcium and vitamin D. If you find it hard to get calcium from your diet because you can't eat dairy products, for example, try calcium supplements, which are often combined with vitamin D. Calcium from supplements is just as effective as calcium from food. What's more, supplements are usually inexpensive, well-tolerated and well-absorbed if taken properly. Good food sources of calcium include milk; low-fat plain yogurt; Swiss, cheddar and ricotta cheeses; broccoli; canned salmon with the bones; and orange juice and other products, such as tofu, fortified with calcium.

  • Exercise regularly. Regular aerobic exercise such as walking or jogging can help prevent bone loss, high blood pressure and diabetes. It also benefits your heart and lungs. In addition, many people find that exercise improves their mood and overall sense of well-being. If you're not used to exercising, start out slowly and build up gradually, aiming for at least 30 minutes on most days. Your doctor can help you plan an exercise program that's right for you.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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