Clinical and Humanistic Burden of Giant Cell Arteritis and the Associated Unmet Medical Needs: A Targeted Literature Review

OBJECTIVES: Giant cell arteritis (GCA) is a disorder of medium and large-sized vessels common in people ≥50 years. Varying clinical manifestations of GCA can be associated with significant burden to patients. While glucocorticoids remain the standard treatment, there is a need for effective alternatives to minimize side effects and maintain remission. The aim of this review was to identify and summarize existing literature on the clinical and humanistic burden of GCA and the associated unmet medical needs.

METHODS: A targeted literature review was conducted in March 2024. Search strategies were applied in MEDLINE, EMBASE, CENTRAL and CDSR. Additionally, hand searches were performed on key congress websites and bibliographic sources. The selection of studies, data extraction and result summarization followed established and current best practices.

RESULTS: A total of 240 publications were included. GCA patients experience ischaemic symptoms (headache, jaw claudication, scalp tenderness, visual disturbances) and systemic symptoms (fatigue, fever, weight loss). Diagnosing GCA can be difficult due to varying presentations. Subsequent treatment delay can result in irreversible vision loss (8-29% patients). GCA patients have an increased risk of aortic aneurysms, ocular manifestations, cardiovascular and cerebrovascular events. Although GCA does not significantly impact long-term mortality, evidence suggests increased mortality shortly after diagnosis due to the increased risk of cardiovascular diseases, which is the leading cause of increased mortality in GCA. GCA significantly impacts patients’ QoL including physical and mental health, impaired daily functioning and increased risk of depression and anxiety. GCA is largely treated with glucocorticoids despite the high rate of relapse and risk associated with long term use, such as osteoporosis, diabetes, infections, and cardiovascular diseases.

CONCLUSIONS: With an ageing population, the overall burden associated with GCA continues to increase significantly due to complications and the safety profile of current treatment options highlighting the need for effective glucocorticoid-sparing alternatives with a favourable safety profile.