{"id":"https://openalex.org/W7225168798","doi":"https://doi.org/10.1093/rap/rkag113.014","title":"OA14 Tocilizumab in steroid-refractory sight-threatening giant cell arteritis","display_name":"OA14 Tocilizumab in steroid-refractory sight-threatening giant cell arteritis","publication_year":2026,"publication_date":"2026-11-01","ids":{"openalex":"https://openalex.org/W7225168798","doi":"https://doi.org/10.1093/rap/rkag113.014"},"language":"en","primary_location":{"id":"doi:10.1093/rap/rkag113.014","doi":"https://doi.org/10.1093/rap/rkag113.014","is_oa":true,"landing_page_url":"https://doi.org/10.1093/rap/rkag113.014","pdf_url":"https://academic.oup.com/rheumap/article-pdf/10/Supplement_1/rkag113.014/72371944/rkag113.014.pdf","source":{"id":"https://openalex.org/S2735938563","display_name":"Rheumatology Advances in Practice","issn_l":"2514-1775","issn":["2514-1775"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatology Advances in Practice","raw_type":"journal-article"},"volume":null,"type":"conference-abstract","is_traditional":false,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://academic.oup.com/rheumap/article-pdf/10/Supplement_1/rkag113.014/72371944/rkag113.014.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5079458821","display_name":"May Myat Mon","orcid":"https://orcid.org/0000-0002-5191-9127","observed_orcids":["https://orcid.org/0000-0002-5191-9127"]},"institutions":[{"id":"https://openalex.org/I2801793805","display_name":"Milton Keynes Hospital","ror":"https://ror.org/05jt1df44","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801793805","https://openalex.org/I4210145072"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"May Myat Mon","raw_affiliation_strings":["Internal Medicine, Milton Keynes University Hospital , Milton Keynes,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Internal Medicine, Milton Keynes University Hospital , Milton Keynes,","institution_ids":["https://openalex.org/I2801793805"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5052364409","display_name":"Eirini Giavri","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801793805","display_name":"Milton Keynes Hospital","ror":"https://ror.org/05jt1df44","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801793805","https://openalex.org/I4210145072"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Eirini Giavri","raw_affiliation_strings":["Rheumatology, Milton Keynes University Hospital , Milton Keynes,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Rheumatology, Milton Keynes University Hospital , Milton Keynes,","institution_ids":["https://openalex.org/I2801793805"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5160527885","display_name":"Shadi Fallahranjbar","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801793805","display_name":"Milton Keynes Hospital","ror":"https://ror.org/05jt1df44","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801793805","https://openalex.org/I4210145072"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Shadi Fallahranjbar","raw_affiliation_strings":["Opthalmology, Milton Keynes University Hospital , Milton Keynes,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Opthalmology, Milton Keynes University Hospital , Milton Keynes,","institution_ids":["https://openalex.org/I2801793805"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I2801793805"],"apc_list":{"value":2255,"currency":"GBP","value_usd":2974},"apc_paid":{"value":2255,"currency":"GBP","value_usd":2974},"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"10","issue":"Supplement_1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10697","display_name":"Vasculitis and related conditions","score":0.9932000041007996,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10697","display_name":"Vasculitis and related conditions","score":0.9932000041007996,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11194","display_name":"Ocular Diseases and Beh\u00e7et\u2019s Syndrome","score":0.0038999998942017555,"subfield":{"id":"https://openalex.org/subfields/2731","display_name":"Ophthalmology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10250","display_name":"Glaucoma and retinal disorders","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2731","display_name":"Ophthalmology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/giant-cell-arteritis","display_name":"giant cell arteritis","score":0.906000018119812},{"id":"https://openalex.org/keywords/tocilizumab","display_name":"tocilizumab","score":0.996999979019165},{"id":"https://openalex.org/keywords/steroid-refractory-disease","display_name":"steroid-refractory disease","score":0.7570000290870667},{"id":"https://openalex.org/keywords/vision-loss","display_name":"vision loss","score":0.5569999814033508},{"id":"https://openalex.org/keywords/anterior-ischemic-optic-neuropathy","display_name":"anterior ischemic optic neuropathy","score":0.8240000009536743},{"id":"https://openalex.org/keywords/optic-disc-edema","display_name":"optic disc edema","score":0.7590000033378601},{"id":"https://openalex.org/keywords/visual-recovery","display_name":"visual recovery","score":0.5619999766349792},{"id":"https://openalex.org/keywords/il-6-receptor-inhibition","display_name":"IL-6 receptor inhibition","score":0.8479999899864197},{"id":"https://openalex.org/keywords/glucocorticoid-side-effects","display_name":"glucocorticoid adverse effects","score":0.7670000195503235},{"id":"https://openalex.org/keywords/temporal-artery-ultrasound","display_name":"temporal artery ultrasound","score":0.5659999847412109},{"id":"https://openalex.org/keywords/retinal-nerve-fiber-layer-thinning","display_name":"retinal nerve fiber layer thinning","score":0.8759999871253967},{"id":"https://openalex.org/keywords/elderly-patients","display_name":"elderly patients","score":0.7580000162124634},{"id":"https://openalex.org/keywords/prednisolone-tapering","display_name":"prednisolone tapering","score":0.7269999980926514},{"id":"https://openalex.org/keywords/subcutaneous-tocilizumab","display_name":"subcutaneous tocilizumab","score":0.8059999942779541}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.949999988079071},{"id":"https://openalex.org/C2779433908","wikidata":"https://www.wikidata.org/wiki/Q2146228","display_name":"Amaurosis fugax","level":3,"score":0.8510000109672546},{"id":"https://openalex.org/C2776712624","wikidata":"https://www.wikidata.org/wiki/Q707816","display_name":"Giant cell arteritis","level":4,"score":0.8321999907493591},{"id":"https://openalex.org/C2777178219","wikidata":"https://www.wikidata.org/wiki/Q425154","display_name":"Tocilizumab","level":3,"score":0.6554999947547913},{"id":"https://openalex.org/C2777748206","wikidata":"https://www.wikidata.org/wiki/Q285787","display_name":"Amaurosis","level":2,"score":0.6373000144958496},{"id":"https://openalex.org/C118487528","wikidata":"https://www.wikidata.org/wiki/Q161437","display_name":"Ophthalmology","level":1,"score":0.4796000123023987},{"id":"https://openalex.org/C2779735895","wikidata":"https://www.wikidata.org/wiki/Q16873995","display_name":"Optic disc","level":3,"score":0.47620001435279846},{"id":"https://openalex.org/C2778257484","wikidata":"https://www.wikidata.org/wiki/Q555066","display_name":"Visual acuity","level":2,"score":0.46219998598098755},{"id":"https://openalex.org/C2776715498","wikidata":"https://www.wikidata.org/wiki/Q11426176","display_name":"Prednisolone","level":2,"score":0.46059998869895935},{"id":"https://openalex.org/C2778233873","wikidata":"https://www.wikidata.org/wiki/Q2879095","display_name":"Optic neuropathy","level":3,"score":0.45980000495910645},{"id":"https://openalex.org/C2776015282","wikidata":"https://www.wikidata.org/wiki/Q644318","display_name":"Vasculitis","level":3,"score":0.4090999960899353},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3903999924659729},{"id":"https://openalex.org/C2778124894","wikidata":"https://www.wikidata.org/wiki/Q2336398","display_name":"Pallor","level":2,"score":0.3686999976634979},{"id":"https://openalex.org/C77076574","wikidata":"https://www.wikidata.org/wiki/Q2152526","display_name":"Giant cell","level":2,"score":0.3382999897003174},{"id":"https://openalex.org/C2781343717","wikidata":"https://www.wikidata.org/wiki/Q1751810","display_name":"Arteritis","level":2,"score":0.3361999988555908},{"id":"https://openalex.org/C2780837183","wikidata":"https://www.wikidata.org/wiki/Q186029","display_name":"Optic nerve","level":2,"score":0.3203999996185303},{"id":"https://openalex.org/C2780662894","wikidata":"https://www.wikidata.org/wiki/Q497574","display_name":"Ophthalmic artery","level":3,"score":0.31450000405311584},{"id":"https://openalex.org/C527108885","wikidata":"https://www.wikidata.org/wiki/Q835153","display_name":"Physical examination","level":2,"score":0.3059999942779541},{"id":"https://openalex.org/C2780498249","wikidata":"https://www.wikidata.org/wiki/Q6079225","display_name":"Ischemic optic neuropathy","level":3,"score":0.29330000281333923},{"id":"https://openalex.org/C2777100477","wikidata":"https://www.wikidata.org/wiki/Q193107","display_name":"Sclera","level":2,"score":0.2752000093460083},{"id":"https://openalex.org/C2780886150","wikidata":"https://www.wikidata.org/wiki/Q152234","display_name":"Edema","level":2,"score":0.2750999927520752},{"id":"https://openalex.org/C2776449918","wikidata":"https://www.wikidata.org/wiki/Q3348620","display_name":"Central retinal artery occlusion","level":3,"score":0.2687999904155731},{"id":"https://openalex.org/C2778720950","wikidata":"https://www.wikidata.org/wiki/Q424972","display_name":"Prednisone","level":2,"score":0.26649999618530273},{"id":"https://openalex.org/C2779159986","wikidata":"https://www.wikidata.org/wiki/Q4930803","display_name":"Blurred vision","level":2,"score":0.2662999927997589}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1093/rap/rkag113.014","doi":"https://doi.org/10.1093/rap/rkag113.014","is_oa":true,"landing_page_url":"https://doi.org/10.1093/rap/rkag113.014","pdf_url":"https://academic.oup.com/rheumap/article-pdf/10/Supplement_1/rkag113.014/72371944/rkag113.014.pdf","source":{"id":"https://openalex.org/S2735938563","display_name":"Rheumatology Advances in Practice","issn_l":"2514-1775","issn":["2514-1775"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatology Advances in Practice","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13728614","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13728614/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13728614/pdf/rkag113.014.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatol Adv Pract","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1093/rap/rkag113.014","doi":"https://doi.org/10.1093/rap/rkag113.014","is_oa":true,"landing_page_url":"https://doi.org/10.1093/rap/rkag113.014","pdf_url":"https://academic.oup.com/rheumap/article-pdf/10/Supplement_1/rkag113.014/72371944/rkag113.014.pdf","source":{"id":"https://openalex.org/S2735938563","display_name":"Rheumatology Advances in Practice","issn_l":"2514-1775","issn":["2514-1775"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatology Advances in Practice","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225168798.pdf","grobid_xml":"https://content.openalex.org/works/W7225168798.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2977329895","https://openalex.org/W2908819732","https://openalex.org/W2976884222","https://openalex.org/W2952670950","https://openalex.org/W4283391374","https://openalex.org/W3134442367","https://openalex.org/W3165197491","https://openalex.org/W2603243658","https://openalex.org/W4286712126","https://openalex.org/W2784384431"],"abstract_inverted_index":{"Abstract":[0],"Introduction":[1],"Bilateral":[2,348],"visual":[3,35,48,129,147,324,383,411,419,451,476,486,506,566,570,576,613,695],"involvement":[4,148,349],"in":[5,62,94,195,202,229,235,333,352,380,385,415,436,440,449,465,520,527,542,579,596,615,636,687],"giant":[6],"cell":[7],"arteritis":[8],"(GCA)":[9],"is":[10,25,326,427,512,525,602,718,727],"uncommon,":[11,413],"particularly":[12,395,514,578,729],"after":[13],"initiation":[14,503],"of":[15,53,122,181,189,226,330,336,356,375,484,518,538,564,673,705,716],"high-dose":[16,370],"glucocorticoids":[17,371],"(GC).":[18],"Tocilizumab":[19,421,679],"(TCZ),":[20,422],"an":[21,423],"interleukin-6":[22,424],"receptor":[23,425],"inhibitor,":[24,426],"effective":[26,379],"for":[27,34,430],"inducing":[28,431],"and":[29,59,83,109,166,186,201,207,219,273,297,377,433,504,554,610,670,692,710,724],"maintaining":[30],"remission,":[31],"though":[32],"evidence":[33,225,445],"recovery":[36,188,412,477,696],"remains":[37,453,639],"limited.":[38,454],"Case":[39],"description":[40],"A":[41],"90-year-old":[42],"woman":[43],"presented":[44],"with":[45,131,137,155,164,184,223,245,257,266,286,306,417,467],"acute":[46,450],"right-eye":[47,238],"loss":[49,325,384],"following":[50],"eight":[51],"weeks":[52],"polymyalgic":[54],"symptoms,":[55],"headaches,":[56],"scalp":[57],"tenderness":[58],"tongue":[60],"claudication":[61],"September":[63],"2025.":[64],"She":[65,302],"developed":[66,126],"transient":[67],"right":[68,79,84,96,196,216,263,522,581],"amaurosis":[69],"fugax":[70],"three":[71],"days":[72,121,361],"prior":[73],"to":[74,168,199,205,243,310,341,354,362,391,405,604],"admission.":[75],"Examination":[76],"showed":[77,214,262],"reduced":[78],"temporal":[80,110,499],"artery":[81,111],"pulsation":[82],"optic":[85,133,141,295,345],"disc":[86,134,212,217,222,227,260,264],"swelling.":[87],"Visual":[88],"acuity":[89],"(VA)":[90],"was":[91,153,584],"counting":[92],"fingers":[93],"the":[95,278,365,373,397,441,516,521,562,572,580,668,703],"eye.":[97],"Inflammatory":[98],"markers":[99,209,732],"were":[100],"markedly":[101,241],"elevated":[102],"(ESR":[103],"89":[104],"mm/hr,":[105],"CRP":[106],"42":[107],"mg/L),":[108],"ultrasound":[112],"demonstrated":[113,439,574],"bilateral":[114,132,146,485,569],"halo":[115],"signs,":[116],"confirming":[117],"GCA.":[118,616,677],"Despite":[119,568],"3":[120],"intravenous":[123,156,489],"methylprednisolone,":[124],"she":[125,152,283],"new":[127,299],"left-eye":[128,251],"symptoms":[130,487],"swelling":[135,228],"consistent":[136],"arteritic":[138,342],"anterior":[139,343],"ischaemic":[140,344,408,565,622],"neuropathy":[142,346],"(AAION).":[143,347],"Given":[144],"progressive":[145,468],"while":[149,250],"on":[150,277,612],"GC,":[151],"treated":[154],"TCZ":[157,171,182,305,460,502,540,589],"(6":[158],"mg/kg),":[159],"followed":[160,508],"by":[161,509,735],"oral":[162,308],"prednisolone":[163,309],"taper":[165],"transition":[167],"weekly":[169,304],"subcutaneous":[170],"(162":[172],"mg).":[173],"Rapid":[174],"subjective":[175],"improvement":[176,519,641],"occurred":[177],"within":[178,360,661],"24":[179],"hours":[180],"administration,":[183],"stabilisation":[185],"partial":[187,323,510],"VA.":[190],"At":[191,232],"ten":[192],"weeks,":[193,363],"VA":[194,239,252,289],"eye":[197,204],"improved":[198,242],"6/47":[200],"left":[203,221,292],"6/24":[206],"inflammatory":[208,731],"normalised.":[210],"Optic":[211,259],"examination":[213,261],"slight":[215],"pallor":[218,265,276],"pink":[220],"no":[224,298],"both.":[230],"Follow-up:":[231],"ophthalmology":[233],"review":[234],"January":[236],"2026,":[237,282],"had":[240],"6/6":[244],"pinhole,":[246],"representing":[247],"unexpected":[248],"recovery,":[249,511],"remained":[253,284],"stable":[254,287],"at":[255],"6/15":[256],"pinhole.":[258],"superior":[267],"retinal":[268],"nerve":[269],"fibre":[270],"layer":[271],"thinning":[272],"possible":[274],"mild":[275],"left.":[279],"By":[280],"April":[281],"asymptomatic":[285],"unaided":[288],"(right":[290],"6/12,":[291],"6/15),":[293],"flat":[294],"discs,":[296],"ophthalmic":[300],"concerns.":[301],"continued":[303],"tapered":[307],"5mg":[311],"once":[312],"daily":[313],"from":[314],"June":[315],"2026":[316],"under":[317],"rheumatology":[318],"follow-up.":[319],"Discussion":[320],"Total":[321],"or":[322,469,545,646],"a":[327,592,682],"serious":[328],"complication":[329],"GCA,":[331,437],"occurring":[332],"approximately":[334],"15\u201320%":[335],"cases,":[337,387,689],"most":[338,386],"commonly":[339],"due":[340],"may":[350,461,590,624,642,653,680],"develop":[351],"up":[353],"25\u201350%":[355],"untreated":[357],"patients,":[358],"often":[359],"highlighting":[364],"narrow":[366],"therapeutic":[367,594],"window.":[368],"Although":[369,529],"remain":[372,697],"cornerstone":[374],"treatment":[376,496,635,725],"are":[378,478,733],"preventing":[381],"further":[382,600],"some":[388],"patients":[389,466],"continue":[390],"deteriorate":[392],"despite":[393,488,627,655],"therapy,":[394],"during":[396],"first":[398],"week.":[399],"Furthermore,":[400],"GC":[401,556],"have":[402,681],"limited":[403],"ability":[404],"reverse":[406],"established":[407,429],"injury,":[409],"making":[410],"especially":[414],"those":[416],"complete":[418],"loss.":[420],"well":[428],"remission":[432],"reducing":[434],"relapse":[435],"as":[438,633,684],"GiACTA":[442],"trial.":[443],"However,":[444],"regarding":[446],"its":[447,606],"role":[448,632,683],"manifestations":[452],"Emerging":[455],"case":[456,549,666,701],"reports":[457],"suggest":[458],"that":[459,551],"help":[462],"stabilise":[463],"vision":[464],"steroid-refractory":[470],"disease,":[471],"although":[472,690],"robust":[473],"data":[474],"demonstrating":[475],"lacking.":[479],"In":[480],"this":[481,534],"case,":[482],"progression":[483],"methylprednisolone":[490],"indicated":[491],"aggressive":[492],"disease":[493,722],"requiring":[494],"early":[495,552],"escalation.":[497],"The":[498,700],"association":[500],"between":[501],"subsequent":[505],"stabilisation,":[507],"notable,":[513],"given":[515],"degree":[517],"eye,":[523,582],"which":[524,583],"rare":[526],"AAION.":[528],"causality":[530,691],"cannot":[531],"be":[532],"established,":[533],"observation":[535],"supports":[536],"consideration":[537],"earlier":[539],"use":[541],"selected":[543,688],"high-risk":[544],"refractory":[546],"patients.":[547],"This":[548,665],"highlights":[550,667],"diagnosis":[553],"guideline-concordant":[555,657],"therapy":[557,686,717],"do":[558],"not":[559],"completely":[560],"eliminate":[561],"risk":[563],"complications.":[567],"loss,":[571],"patient":[573],"significant":[575],"improvement,":[577],"initially":[585],"more":[586],"severely":[587],"affected.":[588],"represent":[591],"promising":[593],"option":[595],"such":[597],"cases;":[598],"however,":[599],"research":[601],"required":[603],"clarify":[605],"efficacy,":[607],"optimal":[608],"timing,":[609],"impact":[611],"outcomes":[614],"Key":[617],"learning":[618],"points":[619],"\u2022":[620,630,650,664,678,699,720],"Progressive":[621],"complications":[623,652],"still":[625],"occur":[626],"glucocorticoid":[628,644,658],"therapy.":[629],"Tocilizumab\u2019s":[631],"rescue":[634,685],"sight-threatening":[637,676],"GCA":[638],"uncertain;":[640],"reflect":[643],"effect":[645],"rapid":[647,706],"IL-6":[648,736],"inhibition.":[649,737],"Ischaemic":[651],"progress":[654],"early,":[656],"treatment,":[659],"even":[660],"fast-track":[662],"pathways.":[663],"diagnostic":[669],"management":[671],"challenges":[672],"acute,":[674],"steroid-refractory,":[675],"mechanisms":[693],"underlying":[694],"uncertain.":[698],"underscores":[702],"importance":[704],"imaging,":[707],"multidisciplinary":[708],"decision-making,":[709],"individualised":[711],"risk\u2013benefit":[712],"assessment":[713],"when":[714,730],"escalation":[715],"required.":[719],"Monitoring":[721],"activity":[723],"response":[726],"challenging,":[728],"suppressed":[734]},"counts_by_year":[],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-11-04T00:00:00"}
