Expert consensus on the diagnosis and treatment of arteritic anterior ischemic optic neuropathy in China_Chinese Journal of Ocular Fundus Diseases

Authors：

 Expert Group of Expert Consensus on the Diagnosis and Treatment of Arteritic Anterior Ischemic Optic Neuropathy in China ,  Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association ,  Neuro-Ophthalmology Society of Chinese Research Hospital Association

Corresponding?author：

Expert Group of Expert Consensus on the Diagnosis and Treatment of Arteritic Anterior Ischemic Optic Neuropathy in China, Email: weishihui706@hotmail.com; Neuro-ophthalmology Group of Ophthalmology Branch of Chinese Medical Association, Email: valentian99@hotmail.com; Neuro-Ophthalmology Society of Chinese Research Hospital Association, Email: chengzhang10@yahoo.com

Keywords：

Arteritic anterior ischemic optic neuropathy; Clinical practice guideline; Expert consensus

DOI：

10.3760/cma.j.cn511434-20251112-00503

Video：

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Abstract Full text Figures/Tables Video References Cited by

Arteritic anterior ischemic optic neuropathy (AAION) is an ischemic lesion of the anterior optic nerve caused by systemic vasculitis. Among people over 50 years old, although its incidence rate in China is lower than that of non-arteritic anterior ischemic optic neuropathy, it often causes a severe drop in vision in one or both eyes and has a very poor prognosis, posing a high risk of blindness. Giant cell arteritis (GCA) is a common cause of AAION, yet its incidence in Asian populations is extremely low according to few reports in China. Given that domestic ophthalmologists still have an insufficient understanding of the clinical manifestations and poor prognosis of GCA at present, the Neuro-Ophthalmology Group of the Ophthalmology Branch of the Chinese Medical Association organized relevant experts to systematically sort out the evidence-based medical evidence at home and abroad. Focusing on GCA as the main cause, this consensus covered aspects such as epidemiology, clinical features, diagnostic criteria, differential diagnosis, treatment and prognosis. This consensus is formulated to comprehensively summarize the relevant knowledge of AAION caused by GCA, aiming to enhance clinical identification and standardize diagnosis and treatment levels, thereby increasing the diagnosis rate and reducing the blindness rate.

1.	Yan Y, Li Z, Luo Y, et al. Biopsy-proven giant cell arteritis associated vision loss in Chinese subjects: a case series and review of the literature[J]. Neuroophthalmology, 2023, 47: 79-87. DOI: 10.1080/01658107.2022.2099427.
2.	Chen Q, Chen W, Feng C, et al. Giant cell arteritis presenting with ocular symptoms: clinical characteristics and multimodal imaging in a Chinese case series[J/OL]. Front Med (Lausanne), 2022, 9: 885463[2022-06-20]. https://pubmed.ncbi.nlm.nih.gov/35795624/. DOI: 10.3389/fmed.2022.885463.
3.	Tian G, Chen W, Chen Q, et al. Giant cell arteritis presenting as bilateral anterior ischemic optic neuropathy: a biopsy-proven case report in Chinese patient[J/OL]. BMC Ophthalmol, 2018, 18: 282[2018-10-30]. https://pubmed.ncbi.nlm.nih.gov/30376812/. DOI: 10.1186/s12886-018-0953-5.
4.	Weyand CM, Goronzy JJ. Giant-cell arteritis and polymyalgia rheumatica[J]. Ann Intern Med, 2003, 139: 505-515. DOI: 10.7326/0003-4819-139-6-200309160-00015.
5.	Pereira LS, Yoon MK, Hwang TN, et al. Giant cell arteritis in Asians: a comparative study[J]. Br J Ophthalmol, 2011, 95: 214-216. DOI: 10.1136/bjo.2009.177220.
6.	Kobayashi S, Yano T, Inaba Y, et al. Ocular involvements of Japanese patients with giant cell arteritis from the first nation-wide survey[J]. Arthritis Rheum, 2003, 49: 867-868. DOI: 10.1002/art.11470.
7.	Baldursson O, Steinsson K, Bjornsson J, et al. Giant cell arteritis in Iceland. An epidemiologic and histopathologic analysis[J]. Arthritis Rheum, 1994, 37: 1007-1012. DOI: 10.1002/art.1780370705.
8.	Salvarani C, Crowson CS, O'fallon WM, et al. Reappraisal of the epidemiology of giant cell arteritis in Olmsted county, Minnesota, over a fifty-year period[J]. Arthritis Rheum, 2004, 51: 264-268. DOI: 10.1002/art.20227.
9.	Sharma A, Mohammad AJ, Turesson C. Incidence and prevalence of giant cell arteritis and polymyalgia rheumatica: a systematic literature review[J]. Semin Arthritis Rheum, 2020, 50: 1040-1048. DOI: 10.1016/j.semarthrit.2020.07.005.
10.	Kobayashi S, Yano T, Matsumoto Y, et al. Clinical and epidemiologic analysis of giant cell (temporal) arteritis from a nationwide survey in 1998 in Japan: the first government-supported nationwide survey[J]. Arthritis Rheum, 2003, 49: 594-598. DOI: 10.1002/art.11195.
11.	Chen JJ, Leavitt JA, Fang C, et al. Evaluating the incidence of arteritic ischemic optic neuropathy and other causes of vision loss from giant cell arteritis[J]. Ophthalmology, 2016, 123: 1999-2003. DOI: 10.1016/j.ophtha.2016.05.008.
12.	Lu P, Hong R, Tian G, et al. Diffusional kurtosis imaging in differentiating nonarteritic anterior ischemic optic neuropathy from acute optic neuritis[J]. Neuroradiology, 2024, 66: 797-807. DOI: 10.1007/s00234-024-03301-6.
13.	Wilkinson IM, Russell RW. Arteries of the head and neck in giant cell arteritis. A pathological study to show the pattern of arterial involvement[J]. Arch Neurol, 1972, 27: 378-391. DOI: 10.1001/archneur.1972.00490170010003.
14.	Weyand CM, Bartley GB. Giant cell arteritis: new concepts in pathogenesis and implications for management[J]. Am J Ophthalmol, 1997, 123: 392-395. DOI: 10.1016/s0002-9394(14)70136-9.
15.	Weyand CM, Ma-Krupa W, Goronzy JJ. Immunopathways in giant cell arteritis and polymyalgia rheumatica[J]. Autoimmun Rev, 2004, 3: 46-53. DOI: 10.1016/S1568-9972(03)00064-8.
16.	Vodopivec I, Rizzo JF 3rd. Ophthalmic manifestations of giant cell arteritis[J]. Rheumatology (Oxford), 2018, 57: 63-72. DOI: 10.1093/rheumatology/kex428.
17.	陳倩, 陳偉民, 馮超逸, 等. 眼部受累的巨細胞動脈炎臨床及影像特征分析[J]. 中國眼耳鼻喉科雜志, 2022, 22(1): 20-24, 30. DOI: 10.14166/j.issn.1671-2420.2022.01.005.Chen Q, Chen WM, Feng CY, et al. Clinical characteristics and imaging features of giant cell arteritis with ocular involvement[J]. Chin J Ophthalmol and Otorhinolaryngol, 2022, 22(1): 20-24, 30. DOI: 10.14166/j.issn.1671-2420.2022.01.005.
18.	Martin-Gutierrez MP, Petzold A, Saihan Z. NAION or not NAION? A literature review of pathogenesis and differential diagnosis of anterior ischaemic optic neuropathies[J]. Eye (Lond), 2024, 38: 418-425. DOI: 10.1038/s41433-023-02716-4.
19.	Casella AMB, Mansour AM, Ec S, et al. Choroidal ischemia as one cardinal sign in giant cell arteritis[J/OL]. Int J Retina Vitreous, 2022, 8(1): 69[2022-09-24]. https://pubmed.ncbi.nlm.nih.gov/36153565/. DOI: 10.1186/s40942-022-00422-z.
20.	Tisavipat N, Stiebel-Kalish H, Palevski D, et al. Acute optic neuropathy in older adults: differentiating between MOGAD optic neuritis and nonarteritic anterior ischemic optic neuropathy[J/OL]. Neurol Neuroimmunol Neuroinflamm, 2024, 11: e200214[2024-03-28]. https://pubmed.ncbi.nlm.nih.gov/38547435/. DOI: 10.1212/NXI.0000000000200214.
21.	Younger DS. Giant cell arteritis[J]. Neurol Clin, 2019, 37: 335-344. DOI: 10.1016/j.ncl.2019.01.008.
22.	Parikh M, Miller NR, Lee AG, et al. Prevalence of a normal C-reactive protein with an elevated erythrocyte sedimentation rate in biopsy-proven giant cell arteritis[J]. Ophthalmology, 2006, 113: 1842-1845. DOI: 10.1016/j.ophtha.2006.05.020.
23.	Hayreh SS, Podhajsky PA, Raman R, et al. Giant cell arteritis: validity and reliability of various diagnostic criteria[J]. Am J Ophthalmol, 1997, 123: 285-296. DOI: 10.1016/s0002-9394(14)70123-0.
24.	Yu E, Chang JR. Giant cell arteritis: updates and controversies[J/OL]. Front Ophthalmol (Lausanne), 2022, 2: 848861[2022-03-17]. https://pubmed.ncbi.nlm.nih.gov/38983551/. DOI: 10.3389/fopht.2022.848861.
25.	Dejaco C, Ramiro S, Bond M, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice: 2023 update[J]. Ann Rheum Dis, 2024, 83: 741-751. DOI: 10.1136/ard-2023-224543.
26.	Nielsen BD, Hansen IT, Kramer S, et al. Simple dichotomous assessment of cranial artery inflammation by conventional 18F-FDG PET/CT shows high accuracy for the diagnosis of giant cell arteritis: a case-control study[J]. Eur J Nucl Med Mol Imaging, 2019, 46: 184-193. DOI: 10.1007/s00259-018-4106-0.
27.	Sammel AM, Hsiao E, Schembri G, et al. Diagnostic accuracy of positron emission tomography/computed tomography of the head, neck, and chest for giant cell arteritis: a prospective, double-blind, cross-sectional study[J]. Arthritis Rheumatol, 2019, 71: 1319-1328. DOI: 10.1002/art.40864.
28.	Nienhuis PH, Sandovici M, Glaudemans AW, et al. Visual and semiquantitative assessment of cranial artery inflammation with FDG-PET/CT in giant cell arteritis[J]. Semin Arthritis Rheum, 2020, 50: 616-623. DOI: 10.1016/j.semarthrit.2020.04.002.
29.	Ponte C, Grayson PC, Robson JC, et al. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis[J]. Ann Rheum Dis, 2022, 81: 1647-1653. DOI: 10.1136/ard-2022-223480.
30.	Buttgereit F, Dejaco C, Matteson EL, et al. Polymyalgia rheumatica and giant cell arteritis: a systematic review[J]. JAMA, 2016, 315: 2442-2458. DOI: 10.1001/jama.2016.5444.
31.	Mazlumzadeh M, Hunder GG, Easley KA, et al. Treatment of giant cell arteritis using induction therapy with high-dose glucocorticoids: a double-blind, placebo-controlled, randomized prospective clinical trial[J]. Arthritis Rheum, 2006, 54: 3310-3318. DOI: 10.1002/art.22163.
32.	Serling-Boyd N, Stone JH. Recent advances in the diagnosis and management of giant cell arteritis[J]. Curr Opin Rheumatol, 2020, 32: 201-207. DOI: 10.1097/BOR.0000000000000700.
33.	Danesh-Meyer H, Savino PJ, Gamble GG. Poor prognosis of visual outcome after visual loss from giant cell arteritis[J]. Ophthalmology, 2005, 112: 1098-1103. DOI: 10.1016/j.ophtha.2005.01.036.
34.	Gonzalez-Gay MA, Vazquez-Rodriguez TR, Lopez-Diaz MJ, et al. Epidemiology of giant cell arteritis and polymyalgia rheumatica[J]. Arthritis Rheum, 2009, 61: 1454-1461. DOI: 10.1002/art.24459.
35.	Hoffman GS, Cid MC, Hellmann DB, et al. A multicenter, randomized, double-blind, placebo-controlled trial of adjuvant methotrexate treatment for giant cell arteritis[J]. Arthritis Rheum, 2002, 46: 1309-1318. DOI: 10.1002/art.10262.
36.	Langford CA, Cuthbertson D, Ytterberg SR, et al. A randomized, double-blind trial of Abatacept (CTLA-4Ig) for the treatment of giant cell arteritis[J]. Arthritis Rheumatol, 2017, 69: 837-845. DOI: 10.1002/art.40044.
37.	Stone JH, Han J, Aringer M, et al. Long-term effect of tocilizumab in patients with giant cell arteritis: open-label extension phase of the Giant Cell Arteritis Actemra (GiACTA) trial[J/OL]. Lancet Rheumatol, 2021, 3: e328-e336[2021-03-19]. https://pubmed.ncbi.nlm.nih.gov/38279390/. DOI: 10.1016/S2665-9913(21)00038-2.
38.	Stone JH, Tuckwell K, Dimonaco S, et al. Trial of Tocilizumab in giant-cell arteritis[J]. N Engl J Med, 2017, 377: 317-328. DOI: 10.1056/NEJMoa1613849.
39.	Quartuccio L, Treppo E, De Martino M, et al. Faster steroid-free remission with tocilizumab compared to methotrexate in giant cell arteritis: a real-life experience in two reference centres[J]. Intern Emerg Med, 2024, 19: 2177-2184. DOI: 10.1007/s11739-024-03722-4.
40.	Tomelleri A, Campochiaro C, Farina N, et al. Effectiveness of a two-year tapered course of tocilizumab in patients with giant cell arteritis: a single-centre prospective study[J/OL]. Semin Arthritis Rheum, 2023, 59: 152174[2023-02-09]. https://pubmed.ncbi.nlm.nih.gov/36774660/. DOI: 10.1016/j.semarthrit.2023.152174.
41.	Spiera RF, Mitnick HJ, Kupersmith M, et al. A prospective, double-blind, randomized, placebo controlled trial of methotrexate in the treatment of giant cell arteritis (GCA)[J]. Clin Exp Rheumatol, 2001, 19: 495-501.
42.	Uddhammar A, Eriksson AL, Nystrom L, et al. Increased mortality due to cardiovascular disease in patients with giant cell arteritis in northern Sweden[J]. J Rheumatol, 2002, 29: 737-742.
43.	Morris CR, Scheib JS. Fatal myocardial infarction resulting from coronary arteritis in a patient with polymyalgia rheumatica and biopsy-proved temporal arteritis. A case report and review of the literature[J]. Arch Intern Med, 1994, 154: 1158-1160.
44.	Evans JM, O'fallon WM, Hunder GG. Increased incidence of aortic aneurysm and dissection in giant cell (temporal) arteritis. A population-based study[J]. Ann Intern Med, 1995, 122: 502-507. DOI: 10.7326/0003-4819-122-7-199504010-00004.
45.	Carroll SC, Gaskin BJ, Danesh-Meyer HV. Giant cell arteritis[J]. Clin Exp Ophthalmol, 2006, 34: 159-173. DOI: 10.1111/j.1442-9071.2006.01186.x.

1. Yan Y, Li Z, Luo Y, et al. Biopsy-proven giant cell arteritis associated vision loss in Chinese subjects: a case series and review of the literature[J]. Neuroophthalmology, 2023, 47: 79-87. DOI: 10.1080/01658107.2022.2099427.
2. Chen Q, Chen W, Feng C, et al. Giant cell arteritis presenting with ocular symptoms: clinical characteristics and multimodal imaging in a Chinese case series[J/OL]. Front Med (Lausanne), 2022, 9: 885463[2022-06-20]. https://pubmed.ncbi.nlm.nih.gov/35795624/. DOI: 10.3389/fmed.2022.885463.
3. Tian G, Chen W, Chen Q, et al. Giant cell arteritis presenting as bilateral anterior ischemic optic neuropathy: a biopsy-proven case report in Chinese patient[J/OL]. BMC Ophthalmol, 2018, 18: 282[2018-10-30]. https://pubmed.ncbi.nlm.nih.gov/30376812/. DOI: 10.1186/s12886-018-0953-5.
4. Weyand CM, Goronzy JJ. Giant-cell arteritis and polymyalgia rheumatica[J]. Ann Intern Med, 2003, 139: 505-515. DOI: 10.7326/0003-4819-139-6-200309160-00015.
5. Pereira LS, Yoon MK, Hwang TN, et al. Giant cell arteritis in Asians: a comparative study[J]. Br J Ophthalmol, 2011, 95: 214-216. DOI: 10.1136/bjo.2009.177220.
6. Kobayashi S, Yano T, Inaba Y, et al. Ocular involvements of Japanese patients with giant cell arteritis from the first nation-wide survey[J]. Arthritis Rheum, 2003, 49: 867-868. DOI: 10.1002/art.11470.
7. Baldursson O, Steinsson K, Bjornsson J, et al. Giant cell arteritis in Iceland. An epidemiologic and histopathologic analysis[J]. Arthritis Rheum, 1994, 37: 1007-1012. DOI: 10.1002/art.1780370705.
8. Salvarani C, Crowson CS, O'fallon WM, et al. Reappraisal of the epidemiology of giant cell arteritis in Olmsted county, Minnesota, over a fifty-year period[J]. Arthritis Rheum, 2004, 51: 264-268. DOI: 10.1002/art.20227.
9. Sharma A, Mohammad AJ, Turesson C. Incidence and prevalence of giant cell arteritis and polymyalgia rheumatica: a systematic literature review[J]. Semin Arthritis Rheum, 2020, 50: 1040-1048. DOI: 10.1016/j.semarthrit.2020.07.005.
10. Kobayashi S, Yano T, Matsumoto Y, et al. Clinical and epidemiologic analysis of giant cell (temporal) arteritis from a nationwide survey in 1998 in Japan: the first government-supported nationwide survey[J]. Arthritis Rheum, 2003, 49: 594-598. DOI: 10.1002/art.11195.
11. Chen JJ, Leavitt JA, Fang C, et al. Evaluating the incidence of arteritic ischemic optic neuropathy and other causes of vision loss from giant cell arteritis[J]. Ophthalmology, 2016, 123: 1999-2003. DOI: 10.1016/j.ophtha.2016.05.008.
12. Lu P, Hong R, Tian G, et al. Diffusional kurtosis imaging in differentiating nonarteritic anterior ischemic optic neuropathy from acute optic neuritis[J]. Neuroradiology, 2024, 66: 797-807. DOI: 10.1007/s00234-024-03301-6.
13. Wilkinson IM, Russell RW. Arteries of the head and neck in giant cell arteritis. A pathological study to show the pattern of arterial involvement[J]. Arch Neurol, 1972, 27: 378-391. DOI: 10.1001/archneur.1972.00490170010003.
14. Weyand CM, Bartley GB. Giant cell arteritis: new concepts in pathogenesis and implications for management[J]. Am J Ophthalmol, 1997, 123: 392-395. DOI: 10.1016/s0002-9394(14)70136-9.
15. Weyand CM, Ma-Krupa W, Goronzy JJ. Immunopathways in giant cell arteritis and polymyalgia rheumatica[J]. Autoimmun Rev, 2004, 3: 46-53. DOI: 10.1016/S1568-9972(03)00064-8.
16. Vodopivec I, Rizzo JF 3rd. Ophthalmic manifestations of giant cell arteritis[J]. Rheumatology (Oxford), 2018, 57: 63-72. DOI: 10.1093/rheumatology/kex428.
17. 陳倩, 陳偉民, 馮超逸, 等. 眼部受累的巨細胞動脈炎臨床及影像特征分析[J]. 中國眼耳鼻喉科雜志, 2022, 22(1): 20-24, 30. DOI: 10.14166/j.issn.1671-2420.2022.01.005.Chen Q, Chen WM, Feng CY, et al. Clinical characteristics and imaging features of giant cell arteritis with ocular involvement[J]. Chin J Ophthalmol and Otorhinolaryngol, 2022, 22(1): 20-24, 30. DOI: 10.14166/j.issn.1671-2420.2022.01.005.
18. Martin-Gutierrez MP, Petzold A, Saihan Z. NAION or not NAION? A literature review of pathogenesis and differential diagnosis of anterior ischaemic optic neuropathies[J]. Eye (Lond), 2024, 38: 418-425. DOI: 10.1038/s41433-023-02716-4.
19. Casella AMB, Mansour AM, Ec S, et al. Choroidal ischemia as one cardinal sign in giant cell arteritis[J/OL]. Int J Retina Vitreous, 2022, 8(1): 69[2022-09-24]. https://pubmed.ncbi.nlm.nih.gov/36153565/. DOI: 10.1186/s40942-022-00422-z.
20. Tisavipat N, Stiebel-Kalish H, Palevski D, et al. Acute optic neuropathy in older adults: differentiating between MOGAD optic neuritis and nonarteritic anterior ischemic optic neuropathy[J/OL]. Neurol Neuroimmunol Neuroinflamm, 2024, 11: e200214[2024-03-28]. https://pubmed.ncbi.nlm.nih.gov/38547435/. DOI: 10.1212/NXI.0000000000200214.
21. Younger DS. Giant cell arteritis[J]. Neurol Clin, 2019, 37: 335-344. DOI: 10.1016/j.ncl.2019.01.008.
22. Parikh M, Miller NR, Lee AG, et al. Prevalence of a normal C-reactive protein with an elevated erythrocyte sedimentation rate in biopsy-proven giant cell arteritis[J]. Ophthalmology, 2006, 113: 1842-1845. DOI: 10.1016/j.ophtha.2006.05.020.
23. Hayreh SS, Podhajsky PA, Raman R, et al. Giant cell arteritis: validity and reliability of various diagnostic criteria[J]. Am J Ophthalmol, 1997, 123: 285-296. DOI: 10.1016/s0002-9394(14)70123-0.
24. Yu E, Chang JR. Giant cell arteritis: updates and controversies[J/OL]. Front Ophthalmol (Lausanne), 2022, 2: 848861[2022-03-17]. https://pubmed.ncbi.nlm.nih.gov/38983551/. DOI: 10.3389/fopht.2022.848861.
25. Dejaco C, Ramiro S, Bond M, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice: 2023 update[J]. Ann Rheum Dis, 2024, 83: 741-751. DOI: 10.1136/ard-2023-224543.
26. Nielsen BD, Hansen IT, Kramer S, et al. Simple dichotomous assessment of cranial artery inflammation by conventional 18F-FDG PET/CT shows high accuracy for the diagnosis of giant cell arteritis: a case-control study[J]. Eur J Nucl Med Mol Imaging, 2019, 46: 184-193. DOI: 10.1007/s00259-018-4106-0.
27. Sammel AM, Hsiao E, Schembri G, et al. Diagnostic accuracy of positron emission tomography/computed tomography of the head, neck, and chest for giant cell arteritis: a prospective, double-blind, cross-sectional study[J]. Arthritis Rheumatol, 2019, 71: 1319-1328. DOI: 10.1002/art.40864.
28. Nienhuis PH, Sandovici M, Glaudemans AW, et al. Visual and semiquantitative assessment of cranial artery inflammation with FDG-PET/CT in giant cell arteritis[J]. Semin Arthritis Rheum, 2020, 50: 616-623. DOI: 10.1016/j.semarthrit.2020.04.002.
29. Ponte C, Grayson PC, Robson JC, et al. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis[J]. Ann Rheum Dis, 2022, 81: 1647-1653. DOI: 10.1136/ard-2022-223480.
30. Buttgereit F, Dejaco C, Matteson EL, et al. Polymyalgia rheumatica and giant cell arteritis: a systematic review[J]. JAMA, 2016, 315: 2442-2458. DOI: 10.1001/jama.2016.5444.
31. Mazlumzadeh M, Hunder GG, Easley KA, et al. Treatment of giant cell arteritis using induction therapy with high-dose glucocorticoids: a double-blind, placebo-controlled, randomized prospective clinical trial[J]. Arthritis Rheum, 2006, 54: 3310-3318. DOI: 10.1002/art.22163.
32. Serling-Boyd N, Stone JH. Recent advances in the diagnosis and management of giant cell arteritis[J]. Curr Opin Rheumatol, 2020, 32: 201-207. DOI: 10.1097/BOR.0000000000000700.
33. Danesh-Meyer H, Savino PJ, Gamble GG. Poor prognosis of visual outcome after visual loss from giant cell arteritis[J]. Ophthalmology, 2005, 112: 1098-1103. DOI: 10.1016/j.ophtha.2005.01.036.
34. Gonzalez-Gay MA, Vazquez-Rodriguez TR, Lopez-Diaz MJ, et al. Epidemiology of giant cell arteritis and polymyalgia rheumatica[J]. Arthritis Rheum, 2009, 61: 1454-1461. DOI: 10.1002/art.24459.
35. Hoffman GS, Cid MC, Hellmann DB, et al. A multicenter, randomized, double-blind, placebo-controlled trial of adjuvant methotrexate treatment for giant cell arteritis[J]. Arthritis Rheum, 2002, 46: 1309-1318. DOI: 10.1002/art.10262.
36. Langford CA, Cuthbertson D, Ytterberg SR, et al. A randomized, double-blind trial of Abatacept (CTLA-4Ig) for the treatment of giant cell arteritis[J]. Arthritis Rheumatol, 2017, 69: 837-845. DOI: 10.1002/art.40044.
37. Stone JH, Han J, Aringer M, et al. Long-term effect of tocilizumab in patients with giant cell arteritis: open-label extension phase of the Giant Cell Arteritis Actemra (GiACTA) trial[J/OL]. Lancet Rheumatol, 2021, 3: e328-e336[2021-03-19]. https://pubmed.ncbi.nlm.nih.gov/38279390/. DOI: 10.1016/S2665-9913(21)00038-2.
38. Stone JH, Tuckwell K, Dimonaco S, et al. Trial of Tocilizumab in giant-cell arteritis[J]. N Engl J Med, 2017, 377: 317-328. DOI: 10.1056/NEJMoa1613849.
39. Quartuccio L, Treppo E, De Martino M, et al. Faster steroid-free remission with tocilizumab compared to methotrexate in giant cell arteritis: a real-life experience in two reference centres[J]. Intern Emerg Med, 2024, 19: 2177-2184. DOI: 10.1007/s11739-024-03722-4.
40. Tomelleri A, Campochiaro C, Farina N, et al. Effectiveness of a two-year tapered course of tocilizumab in patients with giant cell arteritis: a single-centre prospective study[J/OL]. Semin Arthritis Rheum, 2023, 59: 152174[2023-02-09]. https://pubmed.ncbi.nlm.nih.gov/36774660/. DOI: 10.1016/j.semarthrit.2023.152174.
41. Spiera RF, Mitnick HJ, Kupersmith M, et al. A prospective, double-blind, randomized, placebo controlled trial of methotrexate in the treatment of giant cell arteritis (GCA)[J]. Clin Exp Rheumatol, 2001, 19: 495-501.
42. Uddhammar A, Eriksson AL, Nystrom L, et al. Increased mortality due to cardiovascular disease in patients with giant cell arteritis in northern Sweden[J]. J Rheumatol, 2002, 29: 737-742.
43. Morris CR, Scheib JS. Fatal myocardial infarction resulting from coronary arteritis in a patient with polymyalgia rheumatica and biopsy-proved temporal arteritis. A case report and review of the literature[J]. Arch Intern Med, 1994, 154: 1158-1160.
44. Evans JM, O'fallon WM, Hunder GG. Increased incidence of aortic aneurysm and dissection in giant cell (temporal) arteritis. A population-based study[J]. Ann Intern Med, 1995, 122: 502-507. DOI: 10.7326/0003-4819-122-7-199504010-00004.
45. Carroll SC, Gaskin BJ, Danesh-Meyer HV. Giant cell arteritis[J]. Clin Exp Ophthalmol, 2006, 34: 159-173. DOI: 10.1111/j.1442-9071.2006.01186.x.

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