Treatment of giant cell arteritis: current possibilities and prospects of steroid-sparing therapy


DOI: https://dx.doi.org/10.18565/therapy.2023.1.78-88

Meshkov A.D., Maslyansky A.L., Tkacheva O.N., Mazurov V.I.

1) N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow; 2) V.A. Almazov National Medical Research Center of the Ministry of Healthcare of Russia, Saint Petersburg; 3) Saint Petersburg State University; 4) I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg; 5) Clinical Rheumatological Hospital No. 25, Saint Petersburg
Abstract. Approaches to the long-term therapy of giant cell arteritis (GCA) are still remaining underdeveloped. Glucocorticoids (GCS) retain the position of the «gold standard» for the treatment of this disease, but their use in many cases is complicated by the formation of steroid resistance (need for high doses of GCS), steroid dependence (inability to reduce dosages) and a wide range of complications. The role of traditional basic anti-inflammatory medicines (BAMs) in GCA treatment remains uncertain due to the lack of their efficacy and inconclusive evidence base. Current review presents data on the possibility of using targeted synthetic BAMs and genetically engineered biological medicines as second-line remedies in the treatment of GCA with an emphasis on steroid-sparing effect achieving.
Keywords: steroid-sparing therapy, interleukin inhibitors, targeted synthetic basic anti-inflammatory medicines, glucocorticosteroid therapy complications, giant cell arteritis, Janus kinase inhibitors, genetically engineered biological agents, glucocorticosteroids
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About the Autors

Alexey D. Meshkov, PhD in Medical Sciences, rheumatologist, senior researcher at the Laboratory of diseases of the musculoskeletal system, Russian Gerontological Research and Clinical Center of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. E-mail: alexeymeshkov@mail.ru. ORCID: https://orcid.org/0000-0002-5187-0108
Alexey L. Maslyansky, MD, rheumatologist, head of the Research laboratory of rheumatology and immunopathology, V.A. Almazov National Medical Research Center of the Ministry of Healthcare of Russia, professor of the Scientific, Clinical and Educational Center of Gastroenterology and Hepatology of Saint Petersburg State University. Address: 197341, Saint Petersburg, 2 Akkuratova Str. E-mail: esc_4@mail.ru. ORCID: https://orcid.org/0000-0003-2427-4148
Olga N. Tkacheva, MD, professor, head of the Department of diseases of aging of the Faculty of additional professional education, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, director of Russian Gerontological Research and Clinical Center of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Chief freelance geriatrician of the Ministry of Healthcare of Russia. Address: 129226, Moscow, 16 1st Leonova Str. E-mail: rgnkc@rgnkc.ru.
ORCID: https://orcid.org/0000-0002-4193-688X
Vadim I. Mazurov, MD, professor, academician of RAS, Chief scientific consultant, director of the Research Institute of Rheumatology and head of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University, head of the Center for autoimmune diseases of Clinical Rheumatology Hospital No. 25 (Saint Petersburg), Honored Worker of Science of the Russian Federation. Address: 191014, Saint Petersburg, 41 Kirochnaya Str. E-mail: maz.nwgmu@yandex.ru. ORCID: https://orcid.org/0000-0002-0797-2051


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