Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are large-vessel vasculitides affecting the aorta and its branches. Arterial damage from these diseases may result in ischemic complications, aneurysms, and dissections. Despite their similarities, the management of GCA and TAK differs. Glucocorticoids are used frequently but relapses are common, and glucocorticoid toxicity contributes to significant morbidity. Conventional immunosuppressive therapies can be beneficial in TAK, though their role in the management of GCA remains unclear. Tumor necrosis factor inhibitors improve remission rates and appear to limit vascular damage in TAK; these agents are not beneficial in GCA. Tocilizumab is the first biologic glucocorticoid-sparing agent approved for use in GCA and also appears to be effective in TAK. A better understanding of the pathogenesis of both conditions and the availability of targeted therapies hold much promise for future management.

中文翻译：

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大血管血管炎的新治疗方法

巨细胞动脉炎（GCA）和大动脉炎（TAK）是影响主动脉及其分支的大血管血管炎。这些疾病造成的动脉损伤可能导致缺血性并发症、动脉瘤和夹层。尽管 GCA 和 TAK 有相似之处，但它们的管理有所不同。糖皮质激素经常使用，但复发很常见，并且糖皮质激素毒性会导致显着的发病率。传统的免疫抑制疗法对 TAK 可能有益，但其在 GCA 治疗中的作用仍不清楚。肿瘤坏死因子抑制剂可提高 TAK 的缓解率并限制血管损伤；这些药物对 GCA 没有益处。托珠单抗是第一个被批准用于 GCA 的生物糖皮质激素节约剂，并且似乎对 TAK 也有效。更好地了解这两种疾病的发病机制和靶向治疗的可用性为未来的治疗带来了很大希望。