What treatment regimen would you recommend for a patient with biopsy-proven giant cell arteritis and diffuse cutaneous systemic sclerosis?  

This is a challenging situation in which you must weigh the well-known high risk of irreversible blindness in untreated GCA with the known increased risk (but not necessarily 100% risk) of scleroderma renal crisis with steroid exposure >=15mg (Steen and Medsger, PMID 9751093). It is important to ...

Prednisone 0.5 mg - 1 mg/Kg PO QD (counseling patient to check BP daily and report consistently elevated BP readings 20 points higher diastolic or systolic values: concern for precipitating scleroderma renal crisis) and tocilizumab 162 mg SC weekly (as long as no history of diverticulosis). As you k...