Diagnostik und Therapie der Großgefäßvaskulitiden – Wo stehen wir aktuell?

Zusammenfassung

Die beiden Großgefäßvaskulitiden unterscheiden sich in mehrfacher Hinsicht, vor allem aber durch das Alter der betroffenen Patienten bei Erstmanifestation. Die Riesenzellarteriitis (RZA) ist eine Erkrankung des älteren Patienten wohingegen die Takayasu Arteriitis per definitionem vor dem 40 Lebensjahr auftritt. Die Diagnosen sind in den letzten Jahren durch verbesserte Bildgebung und Therapieoptionen mehr ins Bewusstsein gerückt. Neben der klassischen Steroidtherapie – welche bis heute Mittel der ersten Wahl ist – steht uns mit Tocilizumab, einem monoklonalen Antikörper gegen IL6-Rezeptor, zumindest für die RZA, eine zusätzliche hocheffektive Therapie zur Verfügung. Andere vielversprechende Substanzen befinden sich derzeit in Erprobung. Dieser Artikel soll einen Überblick zu Diagnostik und Therapie, aber auch einen Ausblick zu möglicherweise kommenden medikamentösen Optionen bieten.

Abstract

The two forms of large vessel vasculitis differ in a number of ways, but mainly in patient age at first manifestation. Giant cell arteritis (GCA) is a disease of the elderly patient whereas Takayasu arteritis by definition occurs before the age of 40. The diagnoses have gained more awareness in recent years due to improved imaging and treatment options. Besides the classical steroid therapy – which is still the first choice – Tocilizumab, a monoclonal antibody against the IL-6 receptor, provides an additional, highly effective option, at least for the treatment of GCA. Other promising substances are currently being tested. This article aims to provide an overview of diagnostics and therapy, but also an outlook on possible upcoming drug options.

Schlüsselwörter

Großgefäßvaskulitis - Riesenzellarteriitis - Takayasu Arteriitis - Therapie

Key words

Takayasu arteritis - therapy - large vessel vasculitis - giant cell arteritisonline publiziert 2022

Publication History

Article published online:
02 November 2022

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