Neues zur Therapie von Großgefäßvaskulitiden

Large vessel vasculitis, such as giant cell arteritis (GCA) and Takayasu arteritis (TAK) are primarily manifested on large and medium-sized arteries. While GCA mainly affects older people after the 6th decade of life onwards, TAK mainly affects young women under the age of 40 years. Glucocorticoids (GC) are still the standard treatment for both diseases. Refractory courses and relapses in particular often lead to long-term treatment with high cumulative doses of GC, which can lead to increased morbidity and mortality. To date, only the interleukin 6 (IL-6) receptor blocker tocilizumab has been approved for the treatment of GCA. The data on methotrexate and other conventional immunosuppressants are incomplete and in some cases contradictory. The early use of steroid-sparing immunosuppressants is recommended for TAK, although the number of randomized placebo-controlled trials is limited and no steroid-sparing treatment has yet been approved for TAK. For both diseases there is still a great need for modern and safe steroid-sparing treatment that effectively treats vasculitis, prevents damage and enables adequate disease monitoring. This article provides an overview of the current study situation and possible future treatment options for GCA and TAK.