Utilisation de l’azathioprine dans le traitement de l’artérite à cellules géantes

Boureau, Anne Sophie; Faucal, P. De; Espitia, O.; Decker, Luc; Agard, C.

doi:10.1016/j.revmed.2016.03.007

Cited by 12 publications

(4 citation statements)

References 28 publications

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“…One double-blind placebo-controlled study found that subjects needed lesser steroids when treated with azathioprine after 52 weeks whereas another study showed efficacy in GCA but a higher incidence of serious adverse effects such as hepatotoxicity and carcinogenesis. [60][61][62]…”

Section: Dapsonementioning

confidence: 99%

“…Azathioprine is an effective steroid-sparing agent for rheumatoid arthritis, myasthenia gravis, and other connective tissue diseases. One double-blind placebo-controlled study found that subjects needed lesser steroids when treated with azathioprine after 52 weeks whereas another study showed efficacy in GCA but a higher incidence of serious adverse effects such as hepatotoxicity and carcinogenesis 60–62…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Giant Cell Arteritis

Jivraj¹

2023

International Ophthalmology Clinics

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Giant cell arteritis (GCA) is a vasculitis of medium to large-sized blood vessels and is most common in the elderly older than 50 years, in women and whites. 1 The reader is directed to earlier chapters in this manuscript for a detailed discussion on the clinical presentation and diagnostic investigations for GCA. This article will discuss the systemic therapies in GCA. CorticosteroidsUrgent administration of corticosteroids is critical in improving the chances of visual recovery in the affected eye and protecting vision in the fellow eye. After the first eye is involved due to GCA, if untreated, 50% of patients will experience vision loss in the fellow eye within days to weeks. 2 Rapid initiation of corticosteroids may offer a visual benefit to the affected eye as well. In one study, 58% of those who received treatment within 24 hours of developing visual symptoms experienced a symptomatic improvement in vision whereas only 6% of those who were treated in a delayed manner had visual improvement. 3 In those, who have systemic symptoms such as polymyalgia rheumatica, headaches, and jaw pain, can be started on oral prednisone 40 to 60 mg daily and typically respond rapidly to therapy 1 and then can be monitored with a periodic erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) that will help to guide steroid taper.Patients with transient visual disturbances from GCA or those presenting with permanent vision loss require higher doses of corticosteroids.

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Section: Dapsonementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of Giant Cell Arteritis

Jivraj¹

2023

International Ophthalmology Clinics

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“… 74 , 75 Azathioprine demonstrated a modest effect on disease activity in GCA patients when evaluated in a retrospective study in 18/28 patients; 10 patients experienced azathioprine’s serious side effects, leading to treatment discontinuation in 7 cases. 76 …”

Section: Treatmentmentioning

confidence: 99%

Giant Cell Arteritis: State of the Art in Diagnosis, Monitoring, and Treatment

Awisat¹,

Keret²,

Silawy³

et al. 2023

Rambam Maimonides Med J

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Giant cell arteritis (GCA) is the most prevalent subtype of vasculitis in adults. In recent years, there has been substantial improvement in the diagnosis and treatment of GCA, mainly attributed to the introduction of highly sensitive diagnostic tools, incorporation of modern imaging modalities for diagnosis and monitoring of large-vessel vasculitis, and introduction of highly effective novel biological therapies that have revolutionized the field of GCA. This article reviews state-of-the-art approaches for the diagnosis, monitoring, and treatment options of GCA.

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“…When headache is a result of cerebral vasculitis, it remits along with other features of CNS involvement, such that it is a useful feature to follow with presumptively effective vasculitis therapy. The evidencebased systematic approach to the treatment of vasculitis is shown in Table 3 [122,123] or with TCZ a ; AZA [124]; MTX [125--127]; infliximab [128]; and MMF [129]. TAK: EULAR [121]; CS [130]; AZA [131]; RTX [132]; infliximab [133]; anti-TNF-a, anti-IL-6 [134]; and TCZ [135,136].…”

Section: Treatmentmentioning

confidence: 99%

Systemic vasculitis and headache

Younger

2023

Current Opinion in Neurology

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Purpose of review Vasculitis refers to heterogeneous clinicopathologic disorders that share the histopathology of inflammation of blood vessels. Unrecognized and therefore untreated, vasculitis of the nervous system or so called neurovasculitides, lead to pervasive injury and disability making these disorder of paramount importance to clinicians. Recent findings Headache is an important clue to vasculitic involvement of central nervous system (CNS) vessels. CNS vasculitis may be primary, in which only intracranial vessels are involved in the inflammatory process, or secondary to another known disorder with overlapping systemic involvement. A suspicion of vasculitis based on the history, clinical examination, or laboratory studies warrants prompt evaluation and treatment to forestall progression and avert cerebral ischemia or infarction. There has been remarkable progress in the pathogenesis, diagnosis, and treatment of primary adult and pediatric CNS vasculitides predicated on achievements in primary systemic forms. Summary Vasculitis can be diagnosed with certainty after intensive evaluation that includes tissue confirmation whenever possible. Clinicians must choose from among the available immune modulating, suppressive, and targeted immunotherapies to induce and maintain remission status and prevent relapse, tempered by the recognition of anticipated medication side effects.

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Utilisation de l’azathioprine dans le traitement de l’artérite à cellules géantes

Cited by 12 publications

References 28 publications

Treatment of Giant Cell Arteritis

Treatment of Giant Cell Arteritis

Giant Cell Arteritis: State of the Art in Diagnosis, Monitoring, and Treatment

Systemic vasculitis and headache

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