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Advances in Giant Cell Arteritis

Philip Seo, MD, MHS  |  Issue: December 2025  |  November 14, 2025

This study highlights the gap between clinical research and clinical practice. The harms associated with the use of even low-dose glucocorticoids have become clearer just as we have developed alternative therapies for GCA that are safe and effective. Despite these advances, many patients use advanced therapies only after failing glucocorticoid monotherapy and, instead, use low-dose glucocorticoids to maintain remission. This approach may be driven by a number of factors, including physician and patient preferences, and the EULAR guidelines, which advocate for the use of advanced therapies mainly in patients with relapsing or refractory disease.14


Philip Seo, MD, MHS

Philip Seo, MD, MHS, is an associate professor of medicine at Johns Hopkins University School of Medicine. He served as the third physician editor of The Rheumatologist.

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References

  1. Schmidt W, Setty A, Dejaco C, et al. Efficacy and safety of upadacitinib in giant cell arteritis: 2-year results from the re-randomized, double-blind SELECT-GCA phase 3 trial. [abstract 0776]. Arthritis Rheumatol. 2025;77(suppl 9).
  2. Blockmans D, Penn SK, Setty AR, et al. A phase 3 trial of upadacitinib for giant-cell arteritis. N Engl J Med. 2025 May 29;392(20):2013–2024.
  3. Ytterberg SR, Bhatt DL, Mikuls TR, et al. Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis. N Engl J Med. 2022 Jan 27;386(4):316–326.
  4. Buttgereit F, Winthrop K, Calabrese L, et al. Impact of glucocorticoid tapering in giant cell arteritis: analysis from the SELECT-GCA trial [abstract 0895]. Arthritis Rheumatol. 2025;77(suppl 9).
  5. Burmester GR, Deodhar A, Irvine AD, et al. Safety profile of upadacitinib: descriptive analysis in over 27,000 patient-years across rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis, atopic dermatitis, and inflammatory bowel disease. Adv Ther. 2025 Oct;42(10):5215–5237.
  6. Samson M, Bourredjem A, Outh R, et al. methotrexate versus tocilizumab for treatment of giant cell arteritis (METOGiA trial): A multicenter, randomized, controlled trial [abstract 0891]. Arthritis Rheumatol. 2025;77(suppl 9).
  7. Schäfer V. Methotrexate as remission maintenance therapy after remission-induction with tocilizumab and glucocorticoids in giant cell arteritis (MTXinGCA) [NCT05623592]. ClinicalTrials.gov. 2024 Oct 04.
  8. Ni R, Langford R, Kohler M, et al. Diagnostic performance of vascular ultrasound in giant cell arteritis—a single center experience [abstract 2702]. Arthritis Rheumatol. 2025;77(suppl 9).
  9. De Boysson H, Dumont A, Orvain T, et al. Complete metabolic response on PET/CT in giant-cell arteritis-related large vessel vasculitis : Comparison of two strategies using glucocorticoids or glucocorticoids + tocilizumab [abstract 2704]. Arthritis Rheumatol. 2025;77(suppl 9).
  10. Kaymakci MS, Boire NA, Bois MC, et al. Persistent aortic inflammation in patients with giant cell arteritis. Autoimmun Rev. 2023 Sep;22(9):103411.
  11. Quinn KA, Ahlman MA, Grayson PC, et al. Use of 18F-fluorodeoxyglucose positron emission tomography to monitor disease activity in patients with giant cell arteritis on tocilizumab. ACR Open Rheumatol. 2025 Feb;7(2):e11797.
  12. Zeng R, Rebello R, Guggenberger K, et al. Longitudinal changes on cranial magnetic resonance imaging in relapsing giant cell arteritis [abstract 2703]. Arthritis Rheumatol. 2025;77(suppl 9).
  13. Dua A, Kadakia A, Zueger P, et al. Real world steroid burden, treatment patterns and rheumatologists’ perceptions on advanced therapy in giant cell arteritis [abstract 0738]. Arthritis Rheumatol. 2025;77(suppl 9).
  14. Hellmich B, Agueda A, Monti S, et al. 2018 update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2020 Jan;79(1):19–30.

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Filed under:ACR ConvergenceConditionsMeeting ReportsVasculitis Tagged with:AAV FocusRheumACR Convergence 2025ANCA-Associated Vasculitisgiant cell arteritis (GCA)GlucocorticoidsimagingMagnetic resonance imaging (MRI)taperingupadacitinib

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