impact factor, citescore
logo
In press
In Press
Recent issue
Recent issue
Recent Supplement
Recent supplement
archives
Archives
articles free
Free to view
Search
Search
 

Full Papers

 

Turkish Society for Rheumatology recommendations for the diagnosis, follow-up and management of giant cell arteritis

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24

 

  1. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Marmara University, Istanbul, Turkey. falibaz@gmail.com
  2. Division of Rheumatology, Department of Internal Medicine, Izmir City Hospital, Izmir, Turkey.
  3. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Istanbul-Cerrahpasa University, Istanbul, Turkey.
  4. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
  5. Division of Rheumatology, Department of Internal Medicine, University of Health Sciences, Gülhane Faculty of Medicine, Ankara, Turkey.
  6. Division of Rheumatology, Department of Internal Medicine, Antalya Training and Education Hospital, Antalya, Turkey.
  7. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  8. Division of Rheumatology, Department of Internal Medicine, Trakya University, Edirne, Turkey.
  9. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey.
  10. Division of Rheumatology, Department of Internal Medicine, Sakarya Research and Training Hospital, Sakarya, Turkey.
  11. Division of Rheumatology, Ankara Research and Training Hospital, Ankara, Turkey.
  12. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
  13. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
  14. Division of Rheumatology, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey.
  15. Division of Rheumatology, Department of Internal Medicine, Izmir City Hospital, Izmir, Turkey.
  16. Department of Ophthalmology, Marmara University Faculty of Medicine, Istanbul, Turkey.
  17. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey.
  18. Division of Rheumatology, Department of Internal Medicine, Trakya University, Edirne, Turkey.
  19. Division of Rheumatology, Department of Internal Medicine, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey.
  20. Division of Rheumatology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
  21. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  22. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Marmara University, Istanbul, Turkey.
  23. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Istanbul-Cerrahpasa University, Istanbul, Turkey.
  24. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir, Turkey.

CER19636
Full Papers

purchase article

Received: 21/12/2025
Accepted : 17/02/2026
In Press: 24/03/2026

Abstract

OBJECTIVES:
To integrate evidence-based data with expert opinion to provide guidance for the diagnosis, follow-up and treatment of giant cell arteritis (GCA).
METHODS:
A systematic literature review (SLR) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. To structure the key clinical questions, the task force employed the Population, Intervention, Comparison Outcome (PICO) format. The Oxford system was subsequently applied to grade the quality of the evidence and determine the strength of each recommendation.
RESULTS:
This guideline provides 16 recommendations. We recommend the use of methotrexate in addition to glucocorticoids as first-line treatment in all patients with GCA without ischaemic symptoms. We recommend leflunomide, azathioprine and mycophenolate mofetil as alternatives in these patients if methotrexate is not tolerated. We recommend tocilizumab in GCA patients with ischaemic symptoms or with refractoriness to at least one conventional immunosuppressive. We also recommend upadacitinib as an alternative to tocilizumab in patients with low cardiovascular risk. To our knowledge, our recommendations are the first recommending upadacitinib as an alternative treatment option for the treatment of GCA.
CONCLUSIONS:
The large RCTs assessing and comparing new effective options are still required in GCA. Assessment of the value of conventional immunosuppressives, which are more cost-effective options compared to biologic agents, is another research area in GCA treatment especially for developing countries. Upadacitinib seems to be a promising option in GCA. However, more real-life experience is needed to assess the safety of upadacitinib in the elderly population with especially high cardiovascular risk.

Rheumatology Article

Rheumatology Addendum