IV Methylprednisolone in Giant Cell Arteritis Save

A retrospective study in giant cell arteritis (GCA) patients suggests there is no added value using higher dose, intravenous methylprednisolone (IVMP)  in early GCA.

A retrospective analysis of patients with biopsy-confirmed giant cell arteritis (GCA) patients diagnosed from 2004 through 2019, included clinical and laboratory characteristics, and cumulative GC dose and route of administration to compare outcomes in those receiving IVMP vs OGCs oral glucocorticoids (OGC). Primary outcomes were changes in visual acuity (VA), comorbidities, and mortality.

A total of 419 GCA patients (69% female) were included. Steroid treatment was at physician discretion - 119 (94% visual symptom onset) were initially treated with IVMP, and 308 received OGCs only. Visual involvement was verified by an ophthalmologist. 

While IVMP showed a tendency for improvement in visual acuity, results were not statistically significant (OR 1.19, 95% CI 0.35–4.01).  Yet, the IVMP group had a higher risk of newly diagnosed diabetes mellitus (OR 2.59)

There was no difference in survival (mortality) between treatment groups.

No advantage was seen with the use of IVMP.