Where giant cell arteritis treatment is heading

Giant cell arteritis (GCA) is inflammation of large arteries, especially in the head, and is the most common vasculitis in people over 50; roughly 15,000 to 20,000 Americans are diagnosed each year. Untreated, it can cause sudden blindness or stroke. High-dose steroids work quickly but cause serious side effects over the months to years they are needed. Tocilizumab and, since 2025, upadacitinib let people taper steroids faster, and trials now test how short treatment can safely be.

• 52studies open or running
• 6phase 3 trials
• 434papers published this year
• 12NIH-funded projects

1. Now

   Nov 2026

   A pill that spares steroidsHappened 46.4% sustained remission

   Upadacitinib: 46.4% in sustained remission vs 29.0% with placebo, using half as long a steroid taper. FDA approved April 2025.

   46.4%: in sustained remission at 52 weeks, vs 29.0% with placebo.

   • SELECT-GCA trial

   IL-17 blockade fell short in GCAHappened 25.6% sustained remission

   Secukinumab: 25.6% vs 16.9% remission, not statistically significant.

   25.6%: in sustained remission at 52 weeks with 300 mg, vs 16.9% with placebo.

   • GCAptAIN trial (secukinumab)

   But it worked in polymyalgia rheumaticaHappened 41.2% remission in PMR

   Secukinumab doubled remission in relapsing PMR (41.2% vs 20.4%).

   41.2%: in sustained remission at 52 weeks, vs 20.4% with placebo.

   • Secukinumab in polymyalgia rheumatica

2. 6 months

   by May 2027

   Choosing between tocilizumab and upadacitinibLikely

   Guidelines and practice will weigh an injection against a daily pill as the first steroid-sparing drug.

   • SELECT-GCA trial

3. 12 months

   by Nov 2027

   When to stop tocilizumabPossible

   France's MAGICA (120 people, due December 2027) and an NIH trial (due June 2027) test stopping or reducing tocilizumab once disease is controlled.

   • MAGICA
   • NIH tocilizumab trial

4. 3 years

   by late 2029

   Shorter steroid coursesPossible

   CORTODOSE (150 people, due May 2028) and GISCO (178 people, due August 2030) test faster steroid tapers.

   • CORTODOSE
   • GISCO

   AbataceptLong shot

   A University of Pennsylvania trial tests abatacept, a T-cell blocker, for GCA; due December 2029.

   • Abatacept trial

5. 5 years

   by late 2031

   Protecting vessels and visionLong shot

   ASPIRE-GCA tests aspirin to prevent strokes and vision loss, and DERIVE tests drugs to limit long-term artery damage.

   • ASPIRE-GCA
   • DERIVE

The research paths

Borrowed from other conditions

Open to join now

• GCA

  Abatacept

  Phase 3 · 10 sites

  Locations and eligibility →

• GCA

  Steroid tapering schedules

  Phase 3 · 1 site

  Locations and eligibility →

• Well-controlled GCA

  Tocilizumab stop vs reduce

  Phase 2 · 7 sites

  Locations and eligibility →

• Large vessel vasculitis

  Dapagliflozin and bosentan

  Phase 2 · 1 site

  Locations and eligibility →

See every recruiting GCA trial →

When the trials finish

Completion dates the trials registered. Results usually follow 3 to 12 months later.

What just happened

Standard treatment today

• Suspected GCAStart high-dose steroids immediately; confirm with ultrasound or biopsy.
• Confirmed, newSteroids plus tocilizumab or upadacitinib to allow a faster taper.
• RelapsingTocilizumab, upadacitinib or methotrexate.
• Vision loss or strokeIV steroids urgently.

See GCA trials recruiting now →