Tocilizumab in the treatment of polymyalgia rheumatica – a case report


Authors: P. Němec 1;  Šprláková Puková;  A 2;  Z. Řehák 3
Authors‘ workplace: Revmatologická ambulance, II. interní klinika LF MU a FN u sv. Anny v Brně 1;  Klinika radiologie a nukleární medicíny LF MU a FN Brno 2;  Oddělení nukleární medicíny a Regionální centrum aplikované molekulární onkologie, Masarykův onkologický ústav 3
Published in: Čes. Revmatol., 26, 2018, No. 2, p. 88-98.
Category: Case Report

Overview

Polymyalgia rheumatica is the most common inflammatory disorder of people over 50 years of age with peak occurrence in the eighth decene. The fact that the disease affects especially older people causes them to be often individuals with multiple comorbidities and at high risk of adverse effects of treatment. The gold standard for polymyalgia rheumatica treatment remains glucocorticoids. The treatment strategy of the disease should be determined individually so as to optimally balance the benefits and risks of the treatment. Relapses of the disease appear in the course of treatment in 23–55% of patients, depending on the length of their follow-up, and a considerable number of patients experience adverse effects of glucocorticoid therapy. In such patients, methotrexate may be considered. Current recommendations for treatment of polymyalgia rheumatica do not recommend the use of biological drugs, particularly due to lack of evidence of their efficacy, concerns about potential side effects and high treatment prices. However, there is a growing evidence in the literature about the positive effect of tocilizumab in the treatment of polymyalgia rheumatica. The positive effect and safety of tocilizumab in the treatment of polymyalgie rheumatica confirms also our experience.

Key words:

Polymyalgia rheumatica, therapy, glucocorticoids, tocilizuma


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