Аннтотация

This chapter focuses on large vessel vasculitis (LVV), encompassing Giant Cell Arteritis (GCA), Takayasu’s Arteritis (TA) and aortitis defined by the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides [1]. We include Polymyalgia Rheumatica (PMR), which can occur with GCA and aortitis. Glucocorticoids (GC) are the mainstay treatment of large vessel vasculitides and PMR [2- 4]. However, the majority will have flares (>50%), remaining on GC for a minimum of 1- 3 years with their cumulative dose often resulting in side effects [5]. Furthermore, steroid resistance has been frequently recorded in a subset of patients. Relapse remains common despite use of GC and synthetic immunomodulators. We explore the use of biologic therapies and address the unmet need of patients who are resistant or intolerant to GC therapy, along with their use as steroid sparing agents. Having reviewed current literature and clinical trials we will focus our attention on when best to commence biologic therapy and who is most likely to benefit.