American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the typical duration of treatment with prednisone for GCA?

1. 1-3 months

2. 6-18 months

3. 3-6 months

4. Indefinite duration

The correct answer is: 6-18 months

The typical duration of treatment with prednisone for giant cell arteritis (GCA) is important to understand, as GCA is a serious condition that can lead to significant complications, including vision loss if not managed appropriately. In most cases, patients are treated with a high-dose corticosteroid like prednisone initially to control inflammation and prevent complications. After achieving disease control, the treatment is usually continued for a prolonged period, typically ranging from 6 to 18 months. This duration allows for a gradual tapering of the steroid dose as the patient's symptoms improve and laboratory markers (such as ESR or CRP) normalize. Continuous monitoring is essential during this period to assess for any signs of relapse or adverse effects from long-term steroid use. Shorter durations, such as 1-3 months or 3-6 months, may not be adequate for managing this condition fully, as GCA is known for its tendency to recur. An indefinite duration is also not standard practice due to the risks associated with long-term steroid use, including osteoporosis, hypertension, and increased susceptibility to infections. Therefore, the approach is to use the appropriate duration based on individual patient response and risk factors, but generally falling within that 6 to 18-month framework.