PURPOSE OF REVIEW: This article critically reviews the advances in medical 
management of giant cell arteritis (GCA) and Takayasu arteritis (TAK) with a 
focus on recent developments in targeted biologic therapy.
RECENT FINDINGS: The role of biologics in the treatment of large vessel 
vasculitis (LVV) is expanding. TNFα inhibitors appear to be effective in the 
treatment of TAK but have little benefit in GCA. Preliminary clinical trial data 
suggest that abatacept and tocilizumab reduce the risk of relapse in GCA. 
Increasing observational evidence supports the use of interleukin-6 inhibitors 
in TAK. Based on a small open-label study, ustekinumab appears safe and 
potentially effective for refractory GCA. A possible role of B cell 
dysregulation may contribute to pathogenic mechanisms in LVV, but support for 
the use of B cell depleting therapy is limited.
SUMMARY: Interleukin-6 inhibitors appear efficacious in the treatment of 
refractory cases of LVV; however, utility in newly diagnosed 
immunosuppressive-naïve patients is less well established. Abatacept and 
ustekinumab are promising targets for therapy in LVV but further investigation 
is needed before routine use is considered.