Dtsch Med Wochenschr 2018; 143(07): 446-450
DOI: 10.1055/s-0043-114848
Klinischer Fortschritt
Angiologie
© Georg Thieme Verlag KG Stuttgart · New York

Neues zur Diagnostik und Therapie der Riesenzellarteriitis

Current trends in diagnosis and treatment of giant cell arteritis
Michael Czihal
  Med. Klinik und Poliklinik IV, Sektion Angiologie-Gefäßzentrum, Klinikum der Ludwig-Maximilians-Universität, München
,
Christian Lottspeich
  Med. Klinik und Poliklinik IV, Sektion Angiologie-Gefäßzentrum, Klinikum der Ludwig-Maximilians-Universität, München
,
Ulrich Hoffmann
  Med. Klinik und Poliklinik IV, Sektion Angiologie-Gefäßzentrum, Klinikum der Ludwig-Maximilians-Universität, München
› Author Affiliations
Further Information

Publication History

Publication Date:
03 April 2018 (online)

    Permissions and Reprints

Was ist neu?

Bildgebende Diagnostik Eine rein B-Bild-basierte Ultraschalldiagnostik kann die Akzeptanz und den breiten, zeitgerechten Einsatz des Ultraschalls in der Diagnostik der Riesenzellarteriitis befördern und so die Patientenversorgung verbessern. Der Kontrastmittelultraschall könnte einen Stellenwert in der bildgebenden Ad-hoc-Beurteilung der Vaskulitisaktivität bei Riesenzellarteriitis mit Beteiligung extrakranialer Arterien unter Therapie haben.

Therapie Mit dem Interleukin-6-Rezeptor-Antagonisten Tocilizumab steht eine effektive, explizit für die Riesenzellarteriitis zugelassene Therapie zur Verfügung.

Abstract

Giant cell arteritis (GCA) is the most common form of the primary large vessel vasculitides and typically occurs in individuals aged ≥ 50 years. This concise review article discusses current trends in the management of GCA, including important developments in sonographic assessment (B-mode sonography, contrast enhanced ultrasound) and medical treatment (biological treatment with the interleukin-6 receptor alpha inhibitor tocilizumab).

Schlüsselwörter

Riesenzellarteriitis - Ultraschall - Kompressionssonografie - Kontrastmittelsonografie - Interleukin-6 - Tocilizumab

Key words

giant cell arteritis - ultrasound - contrast-enhanced ultrasound - compression ultrasound - interleukin-6 - tocilizumab
 

  • Literatur

  • 1 Czihal M, Lottspeich C, Hoffmann U. Ultrasound imaging in the diagnosis of large vessel vasculitis. Vasa 2017; 46: 241-253
    CrossrefPubMedSearch in Google Scholar
  • 2 Diamantopoulos AP, Haugeberg G, Lindland A. et al. The fast-track ultrasound clinic for early diagnosis of giant cell arteritis significantly reduces permanent visual impairment: towards a more effective strategy to improve clinical outcome in giant cell arteritis?. Rheumatology (Oxford) 2016; 55: 66-70
    CrossrefPubMedSearch in Google Scholar
  • 3 Patil P, Williams M, Maw WW. et al. Fast track pathway reduces sight loss in giant cell arteritis: results of a longitudinal observational cohort study. Clin Exp Rheumatol 2015; 33: S-103-S-106
    Search in Google Scholar
  • 4 Luqmani R, Lee E, Singh S. et al. The Role of Ultrasound Compared to Biopsy of Temporal Arteries in the Diagnosis and Treatment of Giant Cell Arteritis (TABUL): a diagnostic accuracy and cost-effectiveness study. Health Technol Assess 2016; 20: 1-238
    CrossrefPubMedSearch in Google Scholar
  • 5 Schäfer VS, Juche A, Ramiro S. et al. Ultrasound cut-off values for intima-media thickness of temporal, facial and axillary arteries in giant cell arteritis. Rheumatology (Oxford) 2017; 56: 1479-1483
    CrossrefPubMedSearch in Google Scholar
  • 6 Czihal M, Schröttle A, Baustel K. et al. B-mode sonography wall thickness assessment of the temporal and axillary arteries for the diagnosis of giant cell arteritis: a cohort study. Clin Exp Rheumatol 2017; 35: 128-133
    PubMedSearch in Google Scholar
  • 7 Aschwanden M, Daikeler T, Kesten F. et al. Temporal artery compression sign – a novel ultrasound finding for the diagnosis of giant cell arteritis. Ultraschall Med 2013; 34: 47-50
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 Dejaco C, Ramiro S, Duftner C. et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis. . 2018 Jan 22. [Epub ahead of print]
  • 9 Germanò G, Macchioni P, Possemato N. et al. Contrast-Enhanced Ultrasound of the Carotid Artery in Patients With Large Vessel Vasculitis: Correlation With Positron Emission Tomography Findings. Arthritis Care Res (Hoboken) 2017; 69: 143-149
    CrossrefPubMedSearch in Google Scholar
  • 10 Restuccia G, Boiardi L, Cavazza A. et al. Flares in Biopsy-Proven Giant Cell Arteritis in Northern Italy: Characteristics and Predictors in a Long-Term Follow-Up Study. Medicine (Baltimore) 2016; 95: e3524
    CrossrefPubMedSearch in Google Scholar
  • 11 Wilson JC, Sarsour K, Collinson N. et al. Serious adverse effects associated with glucocorticoid therapy in patients with giant cell arteritis (GCA): A nested case-control analysis. Semin Arthritis Rheum 2017; 46: 819-827
    CrossrefPubMedSearch in Google Scholar
  • 12 Liddle J, Bartlam R, Mallen CD. et al. What is the impact of giant cell arteritis on patients’ lives? A UK qualitative study. BMJ Open 2017; 7: e017073
    PubMedSearch in Google Scholar
  • 13 Villiger PM, Adler S, Kuchen S. et al. Tocilizumab for induction and maintenance of remission in giant cell arteritis: a phase 2, randomised, double-blind, placebo-controlled trial. Lancet 2016; 387: 1921-1927
    CrossrefPubMedSearch in Google Scholar
  • 14 Stone JH, Tuckwell K, Dimonaco S. et al. Trial of Tocilizumab in Giant-Cell Arteritis. N Engl J Med 2017; 377: 317-328
    CrossrefPubMedSearch in Google Scholar