Giant Cell Arteritis: Symptoms and Treatment

The Giant Cell Arteritis Program is housed within the Vasculitis Program in the Rheumatology Unit at Massachusetts General Hospital. The aim of the program is to provide high-quality, rapid and longitudinal care to patients with giant cell arteritis and other large vessel vasculitides.  Our team of experts is dedicated to excellence in patient care through early diagnosis, personalized treatment and leading-edge research in giant cell arteritis.

Giant cell arteritis is the most common form of vasculitis affecting patients older than 50 years of age. Giant cell arteritis symptoms include new onset headaches often in the temporal area, scalp sensitivity, claudication (jaw pain or tiredness with chewing) and often pain and stiffness affecting the bilateral shoulders and hips. Untreated giant cell arteritis can lead to permanent vision loss in 10-20% of patients. Vision loss is usually preceded by transient episodes of blurred vision, double vision or vision loss.

The diagnosis of giant cell arteritis is often made with ancillary tests that may include laboratories looking for elevation of markers of inflammation (sedimentation rate and c-reactive protein), vascular imaging including temporal artery ultrasound and temporal artery biopsy.

Giant cell arteritis treatment includes the use of glucocorticoids (e.g., prednisone) and tocilizumab. Occasionally other medications may be used.

The Rheumatology Unit at Mass General has several providers with clinical and research expertise in giant cell arteritis. John Stone, MD, MPH, was the lead global investigator and Sebastian Unizony, MD, was the primary investigator at Mass General of the landmark GiACTA trial, which paved the foundation for the approval of tocilizumab, the first FDA-approved treatment for giant cell arteritis. Under the leadership of Dr. Unizony, the program continues to conduct clinical research trials in giant cell arteritis. Mark Matza, MD, MBA serves as co-investigator alongside Dr. Unizony in the research trials offered at Mass General. The Giant Cell Arteritis Program offers close collaboration with several specialists who have extensive experience in evaluating patients with giant cell arteritis. As necessary, our providers will coordinate care with our team of subspecialty experts, including ophthalmologists and neuro-ophthalmologists, neurologists, radiologists, plastic and oculoplastic surgeons and pathologists. 

Giant Cell Arteritis Treatment: Fast-Track Program

Due to the concern for vision loss, rapid diagnosis and treatment of giant cell arteritis is imperative. Mass General offers a fast-track giant cell arteritis program that promptly evaluates patients suspected to have the disease. The key components of the program are a clinical evaluation by a provider with expertise in giant cell arteritis and a temporal artery ultrasound that is done at the point of care in the rheumatology office. Ultrasound of the temporal arteries is a reliable non-invasive diagnostic test when performed early on during the disease. Sometimes, other testing including a temporal artery biopsy may be required.

The giant cell arteritis fast-track program was started in 2019 by Dr. Matza, who performs most temporal artery ultrasounds in office. Dr. Matza trained extensively to learn this technique and is one of the first rheumatologist in the United States to offer this diagnostic modality. During your visit, you may be evaluated by any one of our rheumatologists who will direct your treatment and diagnostics as appropriate. 

Our providers aim to establish early diagnosis and implement treatment plans with the goal of rapidly controlling symptoms and preventing subsequent disease relapses. To maximize the effectiveness of treatment and to minimize medication side effects, our approach relies on developing a personalized treatment plan for each patient in a timely manner.

Our Research

Browse open clinical trials

The Giant Cell Arteritis Program at Mass General is dedicated to improving the treatment of vasculitis through leading-edge research. Our physicians are engaged in research studies ranging from understanding the biology of vasculitis through laboratory-based research to test new treatments in clinical trials.

We are actively enrolling patients in the following research studies:

Guselkumab for the treatment of Giant Cell Arteritis (ClinicalTrials.gov Identifier: NCT04633447)

More alternatives to control Giant Cell Arteritis symptoms and decrease the exposure to prednisone are needed. This phase 2 clinical trial examines whether 12 months of guselkumab, in combination with 6 months of prednisone, is effective in keeping Giant Cell Arteritis in remission. 

Secukinumab for the treatment of Giant Cell Arteritis (ClinicalTrials.gov Identifier: NCT04930094)

More alternatives to control Giant Cell Arteritis symptoms and decrease the exposure to prednisone are needed. This phase 3 clinical trial examines whether 12 months of secukinumab, in combination with 6 months of prednisone, is effective in keeping Giant Cell Arteritis in remission. 

We have completed the following research studies:

Tocilizumab plus a short prednisone taper for the treatment of giant cell arteritis (ClinicalTrials.gov Identifier: NCT03726749)

Mavrilimumab for the treatment of Giant Cell Arteritis (ClinicalTrials.gov Identifier: NCT03827018)

Ustekinumab for the treatment of Giant Cell Arteritis (ClinicalTrials.gov Identifier: NCT02955147)

Sarilumab for the treatment of Giant Cell Arteritis (ClinicalTrials.gov Identifier: NCT03600805)

Sarilumab for the treatment of Polymyalgia Rheumatica (ClinicalTrials.gov Identifier: NCT03600818)

Sirukumab for the treatment of Giant Cell Arteritis (ClinicalTrials.gov Identifier: NCT02531633