Giant cell arteritis (GCA) is a systemic vasculitis affecting medium- and large-sized arteries — primarily the temporal arteries and aortic branches — almost exclusively in adults over 50. It causes headaches, scalp tenderness, jaw claudication, and carries a significant risk of sudden, permanent vision loss if untreated. It is closely related to polymyalgia rheumatica and requires prompt high-dose corticosteroid treatment.
What's actually going on in research
High-dose prednisone is the immediate treatment and is life-changing in reducing vision loss risk. Tocilizumab (IL-6 receptor inhibitor) is now FDA-approved as a glucocorticoid-sparing agent for GCA following a landmark trial showing it significantly reduces relapses. Trials are investigating other IL-6 inhibitors, JAK inhibitors, IL-17 blockade, and CD28 costimulation blockers (abatacept) for their ability to achieve and maintain remission with less cumulative steroid exposure. Imaging-guided diagnosis and monitoring are also actively studied.
Tocilizumab and IL-6 pathway
Tocilizumab is now standard-of-care for GCA after approval, and sarilumab and other IL-6 pathway drugs are in trials to expand options and evaluate use in large-vessel GCA.
JAK inhibitors
JAK inhibitors including upadacitinib and baricitinib are in mid-phase trials for GCA, offering an oral alternative to injectable biologics that could simplify long-term steroid-sparing therapy.
Large-vessel GCA management
GCA affecting the aorta and its main branches carries distinct risks of aneurysm and dissection; trials are studying imaging surveillance and immunosuppression strategies specifically for large-vessel disease.
What to know before you search
Eligibility typically requires confirmed GCA diagnosis (biopsy or imaging-based), active disease, and current or planned corticosteroid treatment.
What types of trials are currently open
- IL-6 inhibitor trials — Evaluating sarilumab and next-generation IL-6 blockers as alternatives or additions to tocilizumab in GCA.
- JAK inhibitor trials — Testing oral JAK inhibitors for remission maintenance and steroid-sparing in active GCA.
- Large-vessel disease trials — Studying immunosuppression and vascular monitoring strategies for aortic GCA manifestations.
- Vision loss prevention studies — Identifying risk factors and early treatment strategies to prevent ischemic optic neuropathy in GCA.
- Imaging-guided management trials — Using PET-CT and vascular ultrasound to guide treatment decisions and assess remission.
Recently added Giant Cell Arteritis trials
The VGR GCA Cohort: Ultrasound, Biopsy and Biomarkers - Novel Methods for Diagnosis, Monitoring and Prognosis in Giant Cell Arteritis.
Giant cell arteritis (GCA) is the most common vasculitis in the elderly and is usually treated with long-term corticosteroid therapy. Many patients experience relapses and treatment-related side effects. Current diagnostic and monitoring methods provide limited prognostic information and cannot reliably distinguish active from inactive disease during relapse. This project addresses the clinical need for improved tools to identify patients at high risk of relapse and to develop more effective methods for disease monitoring. The aim is to develop new tools that enable more personalized treatment of GCA. By combining vascular ultrasound with novel blood biomarkers, we seek to predict disease course and relapse risk. The specific objectives are: * To identify ultrasound and blood biomarkers that can predict long-term disease control. * To determine which ultrasound parameters and blood biomarkers can distinguish active from inactive disease during treatment. * To evaluate whether extended vascular ultrasound protocols can improve diagnostic accuracy. The ultimate goal is to establish safe, practical tools for improved diagnosis and follow-up in patients with GCA.
Orbital Vascular Inflammation in Ischemic Optic Neuropathy and Giant Cell Arteritis
Giant cell arteritis (GCA) is an inflammation of the blood vessels. A dangerous complication is sudden vision loss due to insufficient blood supply to the optic nerve. However, it is often difficult to distinguish acute vision loss due to GCA from a similar condition of insufficient blood supply to the optic nerve, called NAION. Quick treatment with anti-inflammatory medication is needed in case of GCA to prevent vision loss on the eye and other serious complications. Patients with NAION have no benefit of the medication, but can have serious side effects, why it is very important to differentiate between these conditions. In this project, the investigators will use FDG PET/MRI with Black Blood (BB) sequences and OCT-imaging to study patients with GCA and/or ischemic optic nerve disease. The investigators will look for signs of inflammation in and around the small vessels of the orbit using PET/MRI and study subtle retinal changes using OCT images. The investigators want to answer the following research questions: Do patients with ischemic optic nerve disease and GCA show signs of inflammation in the orbital vessel wall on PET/MRI-scans, that are not present in patients with NAION? Do GCA patients without vision loss, but with signs of orbital vessel wall inflammation on PET/MRI-scans, have a higher risk of later vision loss than GCA patients without? Can subtle changes in the retina, detectable through OCT, help distinguish between GCA-related vision loss and NAION? This will, to our knowledge, be the first study to systematically use FDG PET/MRI BB-scans to illuminate vascular changes in the orbit of patients with GCA and/or ischemic optic nerve disease. The results may improve diagnosis and treatment of GCA and NAION in the future. The investigators hope that this will help prevent blindness and other serious complications in patients with GCA, while also avoiding unnecessary treatments for patients with NAION.
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