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Giant cell arteritis causes inflamed arteries of the scalp, neck, and arms. "Inflamed" means redness or heat, swelling, and pain. The arteries most affected are those in the temples on either side of the head.

Results: 19

Aspirin as an additional treatment for giant cell arteritis

Giant cell arteritis (GCA) is a condition where inflammation destroys the wall of arterial blood vessels usually seen in the head. GCA affects people over the age of 50 years and is more common as people get older. Early on people feel tired and unwell; they have loss of appetite and can lose weight. Most people then develop a new headache, which can make it uncomfortable to touch their hair and scalp. Some people find chewing food uncomfortable. GCA can cause sudden blindness in one or both eyes. Other rare complications include double vision and life‐threatening aneurysms and stroke.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Prednisolone combined with adjunctive immunosuppression is not superior to prednisolone alone in terms of efficacy and safety in giant cell arteritis: meta-analysis

To conduct a meta-analysis of published data of the effectiveness of drug treatment in giant cell arteritis (GCA) to provide evidence to support the optimal use of glucocorticoids (GCs) and adjunct therapy. MEDLINE, CENTRAL and EMBASE searches were used to identify randomised control trials on the treatment of GCA. Studies included were trials in which: (1) the participants were classified as having GCA by the 1990 ACR criteria or biopsy proven disease; (2) parallel-group randomised control of at least 16 weeks duration had been conducted with at least 20 participants; (3) the design included either alternative adjunct immunosuppressant regimens, alternative GCs dosing or routes of administration; and (4) outcome data was included on either relapse rates or rates of infection. One thousand eight hundred thirty-six articles were retrieved, of which only 37 met the primary inclusion criteria. Sixteen of these studies reported some information about the GCs or adjuvant regimen used. Only ten studies were of sufficient quality to be included in the meta-analysis. Together these comprised 638 participants of which 72 % were female. Three studies compared various GCs regimens, with two comparing IV GCs, the latter showing a marginal benefit with respect to relapse (risk ratio (RR) = 0.78, 95 % CI = 0.54 to 1.12) but a greater risk of infection (RR = 1.58, 95 % CI = 0.90 to 2.78). Another three used methotrexate as an adjunctive agent and showed marginal benefit with respect to relapse (RR = 0.85, 95 % CI = 0.66 to 1.11). The remaining four trials compared prednisolone to dapsone, infliximab, adalimumab and hydroxychloroquine, respectively. There are various clinical trials of varying quality. The results from this meta-analysis show that the use of adjunct agents is not associated with improved outcome.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Giant cell arteritis: a systematic review of the qualitative and semiquantitative methods to assess vasculitis with 18F-fluorodeoxyglucose positron emission tomography

Giant cell arteritis (GCA) is the most common vasculitis affecting medium and large vessels. It shows a close clinical association with polymyalgia rheumatica (PMR), a musculoskeletal inflammatory disorder, which is clinically characterized by girdles pain and stiffness. 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is an effective tool for the diagnosis, grading, and follow-up of patients affected by GCA involving the aorta and its proximal branches, but the lack of a standardized method for the assessment of vascular inflammation remains a critical issue, potentially leading to misclassification. In our systematic review, including 19 original articles for a total of 442 GCA patients (with or without PMR symptoms) and 535 healthy controls, we described the different qualitative, semiquantitative and combined methods that have been proposed throughout the literature for assessing the presence and grading the severity of GCA-related vascular inflammation on 18F-FDG PET scans, focusing on the diagnostic performance and examining their respective advantages and limitations. The majority of the included studies adopted qualitative methods of PET image analysis, which are less sensitive but more specific than semiquantitative ones. Among the semiquantitative approaches, the aortic-to-blood pool uptake ratio of the aortic arch seems to be the most accurate method.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Adjunctive methotrexate for treatment of giant cell arteritis: an individual patient data meta-analysis

OBJECTIVE: To reevaluate the efficacy and safety of adjunctive low-dose methotrexate (MTX) in giant cell arteritis (GCA).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Should I send my patient with previous giant cell arteritis for imaging of the thoracic aorta? A systematic literature review and meta-analysis

OBJECTIVES: To review the literature in order to estimate how many previously unknown thoracic aortic aneurysms (TAAs) and thoracic aortic dilatations (TADs) might be detected by systematic, cross-sectional aortic imaging of patients with giant cell arteritis (GCA).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Effect of antiplatelet/anticoagulant therapy on severe ischemic complications in patients with giant cell arteritis: a cumulative meta-analysis

OBJECTIVE: To evaluate the effect of antiplatelet/anticoagulant therapy on the occurrence of severe ischemic complications in GCA patients at diagnosis and while on treatment with corticosteroids (CS), and the risk of bleeding in these patients.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Diagnostic performance of 18F-fluorodeoxyglucose positron emission tomography in giant cell arteritis: a systematic review and meta-analysis

This review concluded that 18F-fluorodeoxyglucose positron emission tomography had valuable diagnostic performance for giant cell arteritis (chronic vascular disease). The review had several methodological weaknesses and the conclusions were based on six small case-control studies (a study design which has been associated with bias in estimates of test performance), so these conclusions are unlikely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Meta-analysis: test performance of ultrasonography for giant-cell arteritis

This generally well-conducted review found that ultrasonography may be helpful in diagnosing giant-cell arteritis, but that it is important to interpret the ultrasound results based on the clinical presentation and pre-test probability of disease. Given the potential for missed studies and the diversity of the included studies, the authors' conservative conclusion seems appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Role of ultrasonography in the diagnosis of temporal arteritis

This review concluded that duplex ultrasonography was relatively accurate for diagnosing temporal arteritis and should become the first-line investigation, with biopsy reserved for patients with negative scans. These conclusions should be interpreted with caution due to the possibility of missing studies, limitations with the quality assessment and analysis and a lack of data on the clinical significance of the findings.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Comparative Value of Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) Testing in Combination Versus Individually for the Diagnosis of Undifferentiated Patients With Suspected Inflammatory Disease or Serious Infection: A Systematic Review and Economic Analysis [Internet]

Patients who have suspected inflammatory disease or serious infection may undergo a diagnostic workup that involves multiple laboratory tests. Two such laboratory tests are erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), non-specific blood tests often ordered together that are well established and widely used to aid the diagnosis of numerous conditions. The simultaneous and widespread use of both tests has raised concerns about their potential overuse, particularly if they provide little valuable information regarding patient management and outcomes.

Cadth Health Technology Assessment - Canadian Agency for Drugs and Technologies in Health.

Version: November 2015
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Self-Harm: Longer-Term Management

This is the first NICE guideline on the longer-term management of both single and recurrent episodes of self-harm.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Version: 2012
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Common Syndromes in Older Adults Related to Primary and Secondary Prevention [Internet]

To create a systematic synthesis of the published evidence about the prevalence of eight geriatric syndromes and their association with survival and institutionalization, and to provide a review of models that report survival in elderly populations.

Evidence Syntheses/Technology Assessments - Agency for Healthcare Research and Quality (US).

Version: July 2011
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Headaches: Diagnosis and Management of Headaches in Young People and Adults [Internet]

Many non-specialist healthcare professionals can find the diagnosis of headache difficult, and both people with headache and their healthcare professionals can be concerned about possible serious underlying causes. This leads to variability in care and may mean that people with headaches are not always offered the most appropriate treatments. People with headache alone are unlikely to have a serious underlying disease. Comparisons between people with headache referred to secondary care and those treated in primary care show that they do not differ in terms of headache impact or disability.

NICE Clinical Guidelines - National Clinical Guideline Centre (UK).

Version: September 2012
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Suspected Cancer: Recognition and Referral

Cancer is an important condition, both in terms of the number of people affected and the impacts on those people and the people close to them. Around one third of a million new cancers are diagnosed annually in the UK, across over 200 different cancer types. Each of these cancer types has different presenting features, though there may be overlap. More than one third of the population will develop a cancer in their lifetime. Although there have been large advances in treatment and survival, with a half of cancer sufferers now living at least ten years after diagnosis, it remains the case that more than a quarter of all people alive now will die of cancer.

NICE Guideline - National Collaborating Centre for Cancer (UK).

Version: June 2015
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A systematic review and economic evaluation of bisphosphonates for the prevention of fragility fractures

The study found that bisphosphonates are effective in preventing fragility fractures. However, the benefit-to-risk ratio in the lowest risk patients may be debatable given the low absolute quality-adjusted life-year gains and the potential for adverse events.

Health Technology Assessment - NIHR Journals Library.

Version: October 2016
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The prognostic utility of tests of platelet function for the detection of ‘aspirin resistance’ in patients with established cardiovascular or cerebrovascular disease: a systematic review and economic evaluation

People with heart disease are often prescribed aspirin. Testing the function of platelets in the blood may be able to assess if aspirin is working properly. This review assessed all the evidence on the results of platelet function testing linked to the risk of having another cardiovascular event (such as a heart attack or stroke). The review found that people classified as ‘aspirin resistant’ by platelet function testing were, on average, slightly more at risk of having another cardiovascular event. However, the increase in risk was very small and it was not certain which was the most accurate of the platelet function tests available. Therefore, at the moment, the result of platelet function testing on its own is not very informative in determining a person’s future risk of cardiovascular events.

Health Technology Assessment - NIHR Journals Library.

Version: May 2015
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Renal Artery Stenosis Management Strategies: An Updated Comparative Effectiveness Review [Internet]

Treatment options for atherosclerotic renal artery stenosis (ARAS) include medical therapy alone or renal artery revascularization with continued medical therapy, most commonly by percutaneous transluminal renal angioplasty with stent placement (PTRAS). This review updates a prior Comparative Effectiveness Review of management strategies for ARAS from 2006, which was updated in 2007.

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US).

Version: August 2016
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The use of fibrin sealant during non-emergency surgery: a systematic review of evidence of benefits and harms

This study found that the effectiveness of fibrin sealants do not appear to vary according to surgical procedures with regard to reducing the risk of seroma or haematoma.

Health Technology Assessment - NIHR Journals Library.

Version: December 2016
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The role of biological agents in the management of large vessel vasculitis (LVV): a systematic review and meta-analysis

BACKGROUND: Giant cell arteritis (GCA) and Takayasu's arteritis (TAA) are large vessel vasculitides (LVV) for which corticosteroids (CS) are the mainstay for treatment. In patients with LVV unable to tolerate CS, biological agents have been used with variable effectiveness.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

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