Abstract
Giant cell arteritis is a type of granulomatous vasculitis that primarily affects the large vessels, particularly the aortic arch and its main and distal branches, in individuals over the age of 50. The treatment of this condition usually necessitates the use of steroid-sparing agents. Among the traditional immunosuppressive medications, methotrexate is the most commonly used, and some research also indicates that leflunomide may be effective. With the introduction of biologic therapies, new treatment options have become available for managing giant cell arteritis. Although the results with tumor necrosis factor alpha inhibitors have been underwhelming in this condition, the inhibition of interleukin 6 through tocilizumab has proven to be a safe and effective treatment choice for giant cell arteritis. This systematic literature review seeks to compile and evaluate all existing clinical evidence regarding the efficacy and safety of biologic disease-modifying antirheumatic drugs that operate through mechanisms other than tumor necrosis factor alpha and interleukin-6 inhibition (including costimulation modulation, interleukin-1 inhibition, interleukin 12/23 inhibition, interleukin 17 inhibition, interleukin 23 inhibition, granulocyte-monocyte colony-stimulating factor inhibition, and B cell depletion) as well as targeted synthetic disease-modifying antirheumatic drugs, such as Janus kinase inhibitors, in patients diagnosed with giant cell arteritis.