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Study: ‘megadose’ steroid therapy no better than oral therapy for GCA

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Intravenous “megadose” steroid therapy was no more effective than oral therapy in preventing visual deterioration in eyes with giant cell arteritis in a large study.

The University of Iowa’s Sohan Hayreh, MD, PhD and Bridget Zimmerman, PhD, examined 144 patients with giant cell arteritis (271 eyes), of whom 91 initially presented with visual loss and 53 did not. All patients were followed while on high doses of systemic corticosteroid therapy for at least 2 weeks.

While on high-dose steroid therapy, either oral or IV, nine patients developed further visual acuity deterioration in one or both eyes within 5 days after the start of therapy. None of the initial patients seen without visual loss developed any visual deterioration. Six of the 48 patients who were on intravenous steroid therapy had visual deterioration, compared with three of 97 who were only on oral steroid therapy.

The study is published in the June issue of Ophthalmology.