#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Polymyalgia rheumatica – is the biological therapy effective?


Authors: A. Pavelková
Authors‘ workplace: Revmatologický ústav, Praha
Published in: Čes. Revmatol., 21, 2013, No. 4, p. 183-188.
Category: Rewiev

Overview

Both polymyalgia rheumatica (PMR) and giant-cell arteritis (temporal arteritis, TA) relatively often affect people in old age, have an acute course and cause significant functional impairment. Manifestations of PMR can often resemble those of rheumatoid arthritis (RA). Thus, to differentiate these conditions may be uneasy. In terms of treatment, RA can be treated with chemical agents, disease modifying antirheumatic drugs and glucocorticoids as well as biological agents.Whereas in PMR, glucocorticoid therapy, associated with the side effect burden, is still the only successful treatment. The use of immunosuppressive therapy appears to be effective in patients with diminished response to glucocorticoids or an inability to use the adequate doses. Considering some common etiopathogenetic mechanisms of these two conditions the efficacy of disease modifying chemical and biological agents of rheumatoid arthritis has also been investigated in polymyalgia rheumatica.

Key words:
Polymyalgia rheumatica, biological therapy, glucocorticoids, anti-TNF therapy


Sources

1. Salvarani C, Cantini F, Hunder G.C. Polymyalgia rheumatica and giant-cell arteritis. Lancet 2008; 372: 234–245.

2. Dasgupta B, Cimmino MA, Maradit-Kramers H. 2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 2012; 71(4): 482–492.

3. Dasgupta B, Borg F, Hassa N, et al. BSR and BHPR guidelines for the management of polymyalgia rheumatica. Oxford: Oxford University Press. 2009.

4. Nothnag T, Leeb BR. Diagnosis, differential diagnosis and treatment of polymyalgia rheumatica. Drug Aging 2006; 23: 391–402.

5. Camellino D,Cimmino MA. Imaging of polymyalgia rheumatica: indications on its pathogenesis, diagnosis and prognosis. Rheumatology 2012; 51(1): 77–86.

6. Healey LA. Polymyalgia rheumatica is the reset of synovitid. J Clin Rheumatol 2006; 12: 165–166.

7. Kreiner F, Langberg H, Galbo H. Increased muscle interstitial levels of inflammatory cytokines in polymyalgia rheumatica. Arthritis Rheum 2010; 62: 3768–75.

8. Alvarez-Rodriguez L, Lopez-Hoyos M, Mata C, et al. Circulating cytokines in active polymyalgia rheumatica. Ann Rheum Dis 2010; 69: 263–9.

9. Martinez-Taboada VM, Alvarez L,Ruiz Soto M. Giant cell arteritis and polymyalgia rheumatica: role of cytokines in the patogenesis and implications for treatment. Cytokine 2008; 44: 207–220.

10. Gabriel S, Sunku J, Salvarani C, et al. Adverse outcomes of antiinflammatory therapy among patients of polymyalgia rheumatica. Arthritis Rheum 1997; 40: 1873–8.

11. Pavelka K. Polymyalgia rheumatica – diagnostika a léčba: Postgraduální medicína 2011; 13: 551–557.

12. Rheumatology Expert Group. Polymyalgia rheumatica and giant cell arteritis. In: Therapeutic Guidelines: rheumatology. Melbourne: Therapeutic Guidelines, 2010.

13. Weyand CM, Fulbright JW, Hunder GG, et al. Treatment of giant cell arteritis: interleukin-6 as a biologic marker of dinase activity. Arthritis Rheum 3: 101, 2000.

14. Štěpán J. Léčba glukokortikoidy indukované osteoporózy. Farmakoterapie 2010; 6, 65–74.

15. Jones G,Halbert J,Crotty M, et al. The effect of treatment on radiological progression in rheumatoid arthritis: a systematic review of randomized placebo-controlled trials. Rheumatology (Oxford) 2003; 42: 6–13.

16. Cimmino MA,Salvarani C, Macchioni P et al. Long-term follow-up of polymyalgia rheumatica patients treated with methotrexate and steroids. Clin Exp Rheumatol 2008; 26: 395–400.

17. Spies CM, Burmester GR,Buttgereit F. Methotrexate treatment in large vessel vasculitis and polymyalgia rheumatica. Clin Exp Rheumatol 2010; 28(5 Suppl61): S172–7.

18. Hernandez-Rodriguez J, CidMC, Lopez-SotoA, Espigol-Frigolé G, BoschX. Tratment of polymyalgia rheumatica: a systemic review. Arch Intern Med 2009; 169: 1839–50.

19. De Silva M,Hazleman BL. Azathioprine in giant cell arteritis/polymyalgia rheumatica: a double-blind study. Ann Rheum Dis 1986; 45: 136–138.

20. Adizie T, Christidis D, Dharmapaliah C, et al. Efficacy and tolerability of leflunomide in difficult-to-treat polymyalgia rheumatica and giant cell arteritis: a case series. Int J Clin Pract 2012; 66: 906–9.

21. Aikawa NE, Pereira RM, Lage L, et al. Anti-TNF therapy for polymyalgia rheumatica: report of 99 cases and review of the literature. Clin Rheumatol 2012; 31: 579–9.

22. Kreiner F, Galbo H. Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial. Arthritis Res Ther 2010; 12: R176.

23. Salvarani C, Cantini F, Niccoli L, et al. Treatment of refractory polymyalgia rheumatica with infliximab: a pilot study. J Rheumatol 2003; 30: 760–3.

24. Salvarani C, Macchioni P, Manzini C, et al. Infliximab plus prednisone or placebo plus prednisone for the initial treatment of polymyalgia rheumatica: a randomized trial. Ann Intern Med 2007; 146: 631–9.

25. Watson P, Gaston H. Response to ´Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial´. Arthritis Res Ther 2011; 13: 403.

26. Bhatia A, Ell P, Edwards J. Anti-CD20 monoclonal antibody (rituximab) as an adjunct in the treatment of giant cell arteritis. Ann Rheum Dis 2005; 64(7): 1099–1100.

27. Unizony S, Stone JH, Stone JR. New treatment strategies in large- vessel vasculitis. Curr Opin Rheumatol 2013; 25(1): 3–9.

28. Unizony S, Arias-Urdaneta L, Miloslavsky E, et al. Tocilizumab for the treatment of large vessel vasculitis (giant cell arteritis, Takayasu arteritis) and polymyalgia rheumatica. Arthritis Care Res 2012; 64: 1720–9.

Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#