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. Author manuscript; available in PMC: 2011 Jan 4.
Published in final edited form as: Rev Neurol Dis. 2008 Summer;5(3):140–152.

Table 1.

Therapeutic Trials of Intravenous Methylprednisolone for Giant Cell Arteritis

Study Design N Population Intervention Primary Endpoint Outcome
Chevalet et al.19 3-armed RCT 164 GCA without ocular
or cerebrovascular
involvement

  1. 1 pulse of 240 mg IV methylprednisolone followed by 0.7 mg/kg oral prednisone

  2. 1 pulse of 240 mg IV methylprednisolone followed by 0.5 mg/kg oral prednisone

  3. Oral prednisone, 0.7 mg/kg

 Cumulative steroid
dose at 1 year		 No benefit with
IV vs oral steroids
Chan et al.21 Retrospective 73 Vision loss from
biopsy-proven GCA

  1. High-dose IV methylprednisolone (~ 1000 mg/d for 3 days), followed by oral, prednisolone at 75 mg/d

  2. Oral prednisolone, 75 mg/d

 Significant
improvement
in visual acuity
on Snellen
chart		 Benefit for IV vs
oral steroids (40%
vs 13%; P = .01)
Hayreh and
Zimmerman11 		Longitudinal
observational		 145 Biopsy-proven GCA

  1. “Megadose” IV dexamethasone (up to 450 mg/d for up to 3 days) followed by oral prednisone, 80-120 mg/d

  2. Oral prednisone alone

 Visual outcome;
cumulative steroid
dose		 No benefit with
IV vs oral steroids
Mazlumzadeh
et al.20 		2-armed RCT 27 GCA without ocular
or cerebrovascular
involvement		 Oral prednisone 40 mg/d
followed by a systematic
taper at week 4, plus an
“induction” dose of:

  1. IV methylprednisolone 15 mg/kg/d for 3 days (~ 1000 mg/d)

  2. 2. Placebo

 Prednisone dose
of no more than
5 mg/d at
36 weeks		 Benefit for IV vs
oral steroids (71%
vs 15%; P = .003)

GCA, giant cell arteritis; IV, intravenous; RCT, randomized controlled trial.