GCA relapse on steroids — SCE Rheumatology MCQ

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HardVasculitisGCA relapse on steroidsSCE Rheumatology

A 79-year-old woman with GCA relapses during prednisolone taper and has steroid-induced diabetes. Examination shows no visual symptoms are present. Investigations show ultrasound confirms active temporal arteritis. What is the most appropriate biologic?

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Correct answer: C — Tocilizumab

Tocilizumab is the targeted biologic most appropriate for this refractory vasculitis phenotype. The alternatives either target a different pathway or lack the same role in this vasculitis scenario. Biologic choice in vasculitis is driven by subtype, organ involvement, relapse pattern and steroid toxicity.

Reference: BSR giant cell arteritis guideline; EULAR large-vessel vasculitis recommendations; BNF