Algorithm for Treating Giant Cell Arteritis (GCA) - Flowchart

Algorithm for Treating Giant Cell Arteritis (GCA) - Flowchart

Algorithm for Treating Giant Cell Arteritis (GCA) - Flowchart Giant Cell Arteritis Giant Cell Arteritis

«Flowchart»

GCA suspected

GCA suspected

GCA suspected

Begin prednisone 60 mg/d

Begin prednisone 60 mg/d

Begin prednisone 60 mg/d

Solumedrol 1000 mg IV/d for 3 days

Solumedrol 1000 mg IV/d for 3 days

Solumedrol 1000 mg IV/d for 3 days

Acute visual loss present

Acute visual loss present

Acute visual loss present

Yes

Yes

Yes

No

No

No

Re-evaluate diagnosis

Re-evaluate diagnosis

Re-evaluate diagnosis

Diagnosis confirmed by biopsy or imaging

Diagnosis confirmed by biopsy or imaging

Diagnosis confirmed by biopsy or imaging

Yes

Yes

Yes

No

No

No

End

End

End

Continue prednisone without tocilizumab

Continue prednisone without tocilizumab

Continue prednisone without tocilizumab

Contraindications to tocilizumab

Contraindications to tocilizumab

Contraindications to tocilizumab

Patient at very high risk of complications from prednisone (e.g., history of osteoporotic fractures)

Patient at very high risk of complications from prednisone (e.g., history of osteoporotic fractures)

Patient at very high risk of complications from prednisone (e.g., history of osteoporotic fractures)

Yes

Yes

Yes

No

No

No

Continue prednisone alone

Continue prednisone alone

Continue prednisone alone

Add tocilizumab162 mg
SC QWK; taper prednisone

Add tocilizumab162 mg
SC QWK; taper prednisone

Add tocilizumab162 mg
SC QWK; taper prednisone

Yes

Yes

Yes

No

No

No

Unacceptable toxicity of prednisone

Unacceptable toxicity of prednisone

Unacceptable toxicity of prednisone

Yes

Yes

Yes

No

No

No