APR 26, 2015
By Andrew G. Lee, MD; Alfredo A. Sadun, MD; Bradley J. Katz, MD, PhD
Committee on Aging
Comprehensive Ophthalmology, Neuro-Ophthalmology/Orbit
This podcast series from the Academy's Committee on Aging features leading experts who discuss clinical experiences and the differences in caring for older adults.
In today's podcast, Drs. Alfredo Sadun and Bradley Katz review the current diagnostic and treatment paradigms for giant cell arteritis (GCA), and the potential of steroid-sparing therapy. Giant cell arteritis typically presents in patients 80 years of age or older, and should always be suspected in the elderly patient who complains of constitutional symptoms that include fatigue and muscular pain, but especially scalp tenderness and jaw claudication. While the mainstay of therapy remains prednisone, and the treatment is highly effective at preventing vision loss, the high-dose regimen and long taper often result in serious systemic effects. Coordinated care with a rheumatologist is critical to long-term management of patients with GCA. Dr. Katz discusses some of the steroid-sparing immunomodulatory drugs under investigation for the treatment of the disease, as well as theories on an infectious etiology or pathogenic component.