What do you use to treat a GCA patient refractory to methotrexate who responded but had adverse effects with both tocilizumab and sarilumab?

This is a challenging group and we don't have a clear answer. Aside from stretching their steroid taper, which is always an option, alternative off label therapies could be considered. From conventional DMARDs, you could try leflunomide. The IL12/23 inhibitor ustekinumab has been studied and has had...