Giant cell arteritis (GCA) is a relapsing large‐vessel vasculitis with risk of serious ischemic manifestations including vision loss and vascular damage in the form of large‐artery stenosis, aneurysms and dissections. Approximately 50% of patients treated with glucocorticoid (GC) monotherapy and 30% of patients receiving adjunctive therapy with tocilizumab experience disease relapses, often during the first 2 years after diagnosis. Although most relapses in GCA do not involve life‐ or organ‐threatening presentations and can be controlled successfully, frequent relapses may lead to increased use of GC and consequent treatment‐related morbidity, in addition to risk of further vascular damage. Emerging data suggests that persistent disease activity may lead to increased vascular morbidity. Additionally, while tocilizumab decreases the frequency of relapses, more than 50% of patients relapse after discontinuation of therapy. Therefore, while interleukin‐6 blockade suppresses disease activity, it does not restore tolerance. In this article, we discuss the practical diagnosis and management of GCA relapses from an expert perspective. Current treatment options for GCA relapses, including those recommended by international guidelines, and novel potential therapies are reviewed.

Marco A Alba

Sebastian Unizony

Kenneth J. Warrington

Giuseppe Murgia

Sergio Prieto‐González

Carlo Salvarani

Eric L. Matteson

Tanaz A Kermani

Arthritis & Rheumatology

Arthritis & Rheumatology, an official journal of the American College of Rheumatology, is a peer-reviewed publication for scientists and clinicians interested in the natural history, pathophysiology, treatment, and outcome of the rheumatic diseases. Arthritis & Rheumatology publishes the highest quality basic and clinical research related to the rheumatic diseases, encompassing a wide range of areas of investigative activity. In addition, the journal publishes review articles, editorials, and other educational material intended for both researchers and clinicians. Serving the worldwide community of rheumatology investigators and clinicians, Arthritis & Rheumatology is known internationally as a top rheumatology research journal.

Arthritis and Rheumatology is the official journal of the American College of Rheumatology, focusing on the natural history, pathophysiology, treatment, and outcomes of rheumatic diseases. This peer-reviewed publication provides high-quality basic and clinical research for scientists and clinicians, covering a wide range of investigative areas. Additionally, the journal publishes review articles, editorials, and other educational materials aimed at both researchers and clinicians. Serving the global community of rheumatology investigators and clinicians, Arthritis and Rheumatology is recognized internationally as a leading journal in rheumatology research.

《Arthritis and Rheumatology》是美国风湿病学会的官方期刊，专注于风湿病的自然历史、病理生理、治疗及其结果。该期刊为科学家和临床医生提供同行评审的高质量基础和临床研究，涵盖广泛的研究领域。此外，期刊还发表综述文章、社论及其他旨在为研究人员和临床医生提供教育材料的内容。《Arthritis and Rheumatology》服务于全球风湿病研究者和临床医生社区，国际上被公认为顶尖的风湿病研究期刊。

Category	Quartile
医学	1
医学, 风湿病学	1

Expert Perspective: Management of Relapses in Giant Cell Arteritis

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