What is the recommended first-line treatment for a patient diagnosed with Giant Cell Arteritis?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

The recommended first-line treatment for Giant Cell Arteritis (GCA) is immediate high-dose glucocorticoids . This is considered a medical emergency due to the significant risk of sudden, irreversible sight loss and other serious complications .

  • For patients with GCA without visual symptoms, the standard initial dose is 40–60 mg oral prednisolone per day .
  • For patients presenting with new visual loss (transient or permanent) or double vision, acute or intermittent visual loss is usually treated with intravenous glucocorticoid therapy (e.g., 500–1000 mg intravenous methylprednisolone daily for up to 3 consecutive days) . If intravenous therapy is not immediately possible, 60–100 mg oral prednisolone may be given for up to 3 consecutive days . Delaying therapy when visual loss is present is the strongest risk factor for permanent blindness [Hellmich, 2020].

Primary care providers should initiate glucocorticoids on strong suspicion of GCA alongside an urgent referral to the local GCA pathway .

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