What initial management is required for someone with giant cell arteritis?
• Shared care is generally recommended, although there may be rare situations where the person is managed solely in primary care (for example if they are very frail or housebound). • If the person is managed solely in primary care, consider discussing management with a specialist. • If symptoms are controlled, reduce the dose of prednisolone slowly. Relapses occur when steroids are reduced too rapidly, particularly in the first two months. The dose reduction should be tailored for each individual. • A suggested schedule is to: • Continue high-dose prednisolone 40–60 mg until symptoms have resolved and erythrocyte sedimentation rate or C-reactive protein level has returned to normal (usually 4 weeks), then • Reduce the dose by 10 mg every 2 weeks until the person is taking 20 mg daily, then • Reduce the dose by 2.5 mg every 2–4 weeks until the person is taking 10 mg daily, then • Reduce the dose by 1 mg every 1–2 months, provided there is no relapse. • One week after any change in dose,
