1. [Giant cell arteritis after the age of 75].
- Author
-
Chevalet P, Masseau-Imbert A, Durand-Fix MH, Agard C, Brisseau JM, Rodat O, and Barrier JH
- Subjects
- Aged, Aged, 80 and over, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Anticoagulants therapeutic use, Drug Monitoring, Female, Frail Elderly, Heparin therapeutic use, Humans, Male, Osteoporosis chemically induced, Osteoporosis prevention & control, Prednisone adverse effects, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Giant Cell Arteritis drug therapy, Prednisone therapeutic use
- Abstract
Despite its increasing incidence giant cell arteritis is not well detected in the elderly. Response to corticosteroid treatment is the same before and after the age of 75, but there are many steroid-induced side effects, particularly bone fractures, in the elderly. Therefore, it is important to reduce the corticosteroid load in elderly and frail people. In this cases, 0.3 to 0.5mg/kg, or 15 to 25mg daily prednisone-equivalent dose at start seems to be enough to prevent blindness in simple forms. This dose has to be rapidly reduced whenever the C-reactive protein remains moderately elevated. Moreover, an anti-agregant or anticoagulant treatment must be associated at the beginning of steroid treatment to prevent ischemic complications, as well as biphosphonates, which could prevent corticosteroid-induced osteoporosis.
- Published
- 2002