New blood biomarkers and imaging for disease stratification and monitoring of giant cell arteritis

• Published in: Rheumatic & musculoskeletal diseases open Vol. 10; no. 1; p. e003397
• Main Authors: Tomelleri, Alessandro, Dejaco, Christian
• Format: Journal Article
• Language: English
• Published: England EULAR 23.02.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Viewpoint
• Subjects: Angiogenesis; Aortic aneurysms; Biomarkers; Coronary vessels; Cytokines; Diagnostic Imaging; Giant Cell Arteritis; Giant Cell Arteritis - complications; Giant Cell Arteritis - diagnostic imaging; Glucocorticoids - therapeutic use; Humans; Interleukin-6; Kinases; Medical imaging; Outcome and Process Assessment, Health Care; Positron Emission Tomography Computed Tomography; Proteins; Remission (Medicine); Tomography; Ultrasonic imaging; Ultrasonography; Vasculitis; Vein & artery diseases; Outcome and Process Assessment, Health Care; Giant Cell Arteritis; Vasculitis; Cytokines; Ultrasonography
• ISSN: 2056-5933; 2056-5933
• DOI: 10.1136/rmdopen-2023-003397

Relapses and late complications remain a concern in giant cell arteritis (GCA). Monitoring strategies are required to effectively tailor treatment and improve patients’ outcomes. Current monitoring of GCA is based on clinical assessment and evaluation of traditional inflammatory markers such as C reactive protein and erythrocyte sedimentation rate; however, this approach has limited value in patients receiving interleukin (IL)-6 blocking agents. New blood biomarkers that are less dependent on the IL-6 axis such as IL-23, B cell activating factor, osteopontin and calprotectin have been explored, but none of them has yet accumulated sufficient evidence to qualify as a routine follow-up parameter. Imaging techniques, including ultrasound and 18F-fluorodeoxyglucose positron emission tomography/computed tomography, potentially offer additional insights; however, the choice of the imaging method as well as its interpretation must be investigated further. Future studies are required to investigate the outcome of patients with GCA whose treatment decisions are based on traditional plus novel (laboratory and imaging) biomarkers as compared with those undergoing conventional monitoring strategies.