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Patients with giant cell arteritis (GCA) often receive corticosteroids for more than a year. To determine whether high-dose “induction therapy” can reduce long-term requirements for steroids, researchers conducted this double-blind randomized trial.
Twenty-seven patients with biopsy-proven GCA received either high-dose pulse intravenous methylprednisolone (15 mg/kg/day for 3 days) or placebo. In addition, all patients initially received oral prednisone (40 mg/day), and doses were gradually tapered or increased according to a protocol that incorporated both clinical criteria and targets for the sedimentation rate and C-reactive protein level.
The primary outcome — the proportion of patients taking 5 mg or less of prednisone daily at 36 weeks —…