Giant cell arteritis (GCA) is a systemic inflammatory vasculitis affecting 
medium and large vessels with potentially sight and life-threatening 
complications. Early diagnosis and prompt treatment are imperative in order to 
prevent vision loss and progression of the disease. Erythrocyte sedimentation 
rate (ESR) and C-reactive protein (CRP) are inflammatory markers which are 
elevated in the majority of patients and support the diagnosis of GCA among 
patients who present with typical symptoms. GCA is confirmed with superficial 
temporal artery biopsy which demonstrates characteristic pathological findings. 
Treatment of suspected ophthalmic involvement must be initiated urgently, even 
when diagnostic studies are pending. High dose corticosteroid therapy is the 
mainstay of treatment and is administered either intravenously or orally to 
prevent further vision loss and treat systemic vasculitis. Oral corticosteroid 
therapy is required for months to years with careful follow-up and periodic 
laboratory evaluations with ESR and CRP. Corticosteroids are tapered gradually 
over months and may be associated with complications such as hypertension, 
diabetes mellitus, osteoporosis, psychosis, peptic ulcer disease, and infection. 
Supplementation with calcium, vitamin D, bisphosphonate therapy, antimicrobial 
prophylaxis, and initiation of a proton pump inhibitor or Histamine H2-receptor 
antagonist should be considered. Recurrence of inflammation is common in GCA and 
necessitates an escalation of corticosteroid dose. Adjunctive immunomodulatory 
therapy may be considered in patients experiencing relapsing inflammation 
despite high doses of corticosteroids or those with corticosteroid-induced 
complications. Emerging evidence for adjunctive therapy with tocilizumab, 
methotrexate, aspirin, angiotensin receptor blockers, and statins is encouraging 
and may lead to a more mainstream role for these therapies among patients with 
GCA.