Therapeutic target
- Pain relief
Therapy recommendations
- After diagnosis, immediate initiation of therapy: prednisolone (glucocorticoids).
- If necessary, in combination with in combination with methotrexate (MTX (immunosuppressants / drugs that reduce the functions of the immune system)/ esp. in recurrent courses and in cases where it is not possible to reduce the steroid dose to or below the so-called Cushing’s threshold of 7.5 mg prednisone.
- The recurrence rate is circa 30%. Maintenance therapy of at least one year can help to reduce the risk of recurrence; often a much longer therapy (2 to 3 years) is required, possibly lifelong.
- In giant cell arteritis (fleeting visual disturbances!): immediate intravenous high-dose steroid therapy, see below of the disease of the same name.
- Acetylsalicylic acid (for prevention of ischemic complications/complications due to reduced blood flow).
- See also under “Other therapy.”
Further notes
- Dose reduction of prednisone should be accompanied by controls of inflammatory parameters inflammatory parameters (ESR and CRP). However, clinical response is paramount; laboratory parameters are for confirmation only.
- Note due torisk of osteoporosis (bone loss) under glucocorticoid therapy supplementation with calcium and vitamin D and bone densitometry in DXA technique.
