7
Table 4. Recommendations/Statements for Treatment
(Medical and Surgical Management) and Clinical/
Laboratory Monitoring in GCA
B. Surgical Management Level of Evidence
Ungraded Position Statement: For any patient requiring
surgical vascular intervention for GCA, the type and timing
of intervention should be a collaborative decision between the
vascular surgeon and rheumatologist.
N/A
In patients with severe GCA and worsening signs of limb/organ
ischemia on immunosuppression, we conditionally recommend
escalating immunosuppression over surgical intervention with
escalation of immunosuppression.
Very low / Low
In patients with GCA undergoing vascular surgical intervention,
we conditionally recommend using high dose glucocorticoids
during the peri-procedural period if the patient has active disease.
Very low
C. Clinical/Laboratory Monitoring Level of Evidence
In patients with GCA in apparent remission, we strongly
recommend long-term clinical monitoring over no clinical
monitoring.
Very low / Low
In patients with GCA who have rising inflammatory markers
alone, we conditionally recommend clinical observation and
monitoring without escalation of immunosuppression.
Very low
(cont'd)
