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Giant Cell Arteritis — SCE Rheumatology MCQ

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ModerateVasculitisGiant Cell ArteritisSCE Rheumatology

A 62-year-old woman with GCA on Prednisolone 50 mg daily has ESR normalise and symptoms resolve within 1 week. According to BSR guidelines what is the recommended initial tapering schedule for Prednisolone in GCA?

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Correct answer: A — Reduce to 40 mg after 2 weeks then by 5 mg every 2-4 weeks to 15 mg then by 1-2.5 mg every 2-4 weeks

BSR 2020 GCA guidelines recommend a structured tapering regimen: initial dose (40-60 mg) for 2-4 weeks, then reduce to 40 mg, then reduce by 5 mg every 2-4 weeks to 15 mg, then reduce by 1-2.5 mg every 2-4 weeks thereafter. Total treatment duration is typically 18-24 months minimum. Flares during tapering should prompt a return to the previous effective dose. Tocilizumab can be added as a steroid-sparing agent for relapsing disease.

Reference: BSR 2020 - Guidelines for management of giant cell arteritis