Mayo Clinic researchers have discovered an effective new way to treat giant cell arteritis (GCA), a debilitating cause of headaches, fatigue, muscle pain and even blindness. The findings of this research will be presented at the American College of Rheumatology Annual Scientific Meeting.
In his presentation, Mayo Clinic rheumatologist Mehrdad Mazlumzadeh, M.D., will report that initial treatment of GCA using high doses of intravenous steroid hormones called methylprednisolone was effective in controlling the disease and shortening the length of treatment. The new approach not only allowed a more rapid reduction in dosage of prednisone, a drug commonly used to manage the disease, but it also helped delay recurrence of symptoms.
“We found that these patients do better clinically,” said Dr. Mazlumzadeh. “We want to not only bring relief to patients, but also reduce their risk of complications that can result from prolonged treatment of GCA with oral prednisone, the first-line treatment.”
Although there is no cure for GCA, prednisone reduces inflammation. Prednisone also can produce unpleasant and even severe side effects such as increased blood pressure, diabetes, weakening or thinning of the bones, increased cholesterol and clogging of the arteries. The goal of Dr. Mazlumzadeh’s study was to alleviate symptoms of GCA while reducing or eliminating the need for long-term treatment with prednisone.
Dr. Mazlumzadeh’s study was a randomized, double-blind placebo-controlled evaluation of 27 patients with confirmed cases of GCA. All 27 patients received oral prednisone, but 14 were given intravenous methylprednisolone. The other 13 were given a placebo, a harmless substitute solution of water and salt.
Neither researchers nor patients knew who received the active or placebo treatments until after the treatment period. In the first 34 weeks of the study, 10 of 14 patients (or 71.4 percent) receiving the active treatment could reduce their medication (prednisone) to just 5 milligrams or less per day. Meanwhile, of the patients receiving only the placebo treatment, only two (or 15.4 percent) responded well enough to reduce their prednisone to the same extent.
“The differences between the two treatment groups remained significant on follow-up,” noted Dr. Mazlumzadeh.
Additionally, the patient group receiving the placebo treatment had more frequent flare-ups of the disease in comparison to the group receiving the active treatment, according to Dr. Mazlumzadeh.
GCA is an inflammation of the arteries, particularly those in the head, neck and arms. GCA is found in about 200 of every 100,000 people over the age of 50. It primarily affects people ages 50 and older, and women more than men. The incidence of GCA increases as one ages. In addition to causing severe headaches, GCA also can cause tenderness in the scalp and stiffness and muscle pain throughout the body. If left untreated, or if treatment is delayed, it can cause arteries to swell to the point that blindness and even fatal stroke can occur. GCA is confirmed through a sample taken from an artery in the temple.