Neurology® Podcast A Phase 3 Trial of Upadacitinib for Giant-Cell Arteritis
Jul 28, 2025
Dr. Daniel Blockmans, an internist from the University Hospital Gassisbury and an expert on giant cell arteritis, discusses groundbreaking findings on upadacitinib as a treatment alternative. He addresses the limitations of traditional glucocorticoid therapies and shares results from a Phase 3 trial showing upadacitinib's potential for sustained remission. The conversation also touches upon the safety profile, comparing it with tocilizumab and noting the importance of monitoring for opportunistic infections. Insights into differing treatment guidelines across regions add depth to the discourse.
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Giant Cell Arteritis Basics
- Giant cell arteritis (GCA) primarily affects patients over 50 years old with classic symptoms like headache and jaw claudication.
- It can also present atypically with fever, weight loss, or polymyalgia rheumatica in about 50% of cases.
Steroid Challenges in GCA Treatment
- Steroids remain the main treatment for GCA but cause many side effects and relapses upon tapering.
- About half of patients treated only with steroids eventually relapse, highlighting the need for better options.
SELECT-GCA Trial Design Overview
- The SELECT-GCA trial enrolled 428 patients comparing upadacitinib 15 mg or 7.5 mg plus steroid taper versus steroids alone.
- Treatment groups showed that upadacitinib combined with faster steroid taper was tested against the standard 52-week steroid regimen.