The fields of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) have advanced rapidly, resulting in a new understanding of these diseases. Fast-track strategies and improved awareness programmes that prevent irreversible sight loss through early diagnosis and treatment are a notable advance. Ultrasonography and other imaging techniques have been introduced into routine clinical practice and there have been promising reports on the efficacy of biologic agents, particularly IL-6 antagonists such as tocilizumab, in treating these conditions. Along with these developments, which should improve outcomes in patients with GCA and PMR, new questions and unmet needs have emerged; future research should address which pathogenetic mechanisms contribute to the different phases and clinical phenotypes of GCA, what role imaging has in the early diagnosis and monitoring of GCA and PMR, and in which patients and phases of these diseases novel biologic drugs should be used. This article discusses the implications of recent developments in our understanding of GCA and PMR, as well as the unmet needs concerning epidemiology, pathogenesis, imaging and treatment of these diseases.

中文翻译：

---

巨细胞动脉炎和风湿性多肌痛：当前的挑战和机遇

巨细胞动脉炎（GCA）和风湿性多肌痛（PMR）领域发展迅速，对这些疾病有了新的认识。通过早期诊断和治疗来防止不可逆视力丧失的快速策略和提高意识的计划是一项显着进步。超声检查和其他成像技术已被引入常规临床实践中，并且有关于生物剂，特别是IL-6拮抗剂（例如tocilizumab）在治疗这些疾病中的功效的有前途的报道。随着这些进展，应该会改善GCA和PMR患者的预后，出现了新的问题和未满足的需求。未来的研究应探讨哪些致病机制导致了GCA的不同阶段和临床表型，影像学在早期诊断和监测GCA和PMR中起什么作用，以及在这些疾病的患者和阶段中应使用新的生物药物。本文讨论了最新进展对我们对GCA和PMR的理解以及对这些疾病的流行病学，发病机制，影像学和治疗的未满足需求。