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Biologicals: A Perspective for the Treatment of PMR/GCA

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Polymyalgia Rheumatica and Giant Cell Arteritis

Abstract

Polymyalgia rheumatica and giant cell arteritis are diseases with an exceptionally favorable response to glucocorticoid (GCs) treatment. It is well known and a consensus that corticosteroid therapy usually leads to a rapid and dramatic improvement of patients’ complaints and returns them to previous functional status [1, 2]. Almost immediate pain relief after initiation of corticosteroids can be regarded as an additional diagnostic feature for PMR [3]. If no significant pain reduction can be achieved by an adequate steroid dose, the diagnosis must be seriously, and maybe repetitively, reconsidered.

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References

  1. Nothnagl T, Leeb BF. Diagnosis, differential diagnosis and treatment of polymyalgia rheumatica. Drugs Aging. 2006;23(5):391–402.

    Article  PubMed  Google Scholar 

  2. Hunder GG. Giant cell arteritis and polymyalgia rheumatica. Med Clin North Am. 1997;81:195–219.

    Article  CAS  PubMed  Google Scholar 

  3. Bird HA, Esselinckx W, Dixon AS, et al. An evaluation of criteria for polymyalgia rheumatica. Ann Rheum Dis. 1979;38:434–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Dejaco C, Singh YP, Perel P, Hutchings A, Camellino D, Mackie S, Abril A, Bachta A, Balint P, Barraclough K, Bianconi L, Buttgereit F, Carsons S, Ching D, Cid M, Cimmino M, Diamantopoulos A, Docken W, Duftner C, Fashanu B, Gilbert K, Hildreth P, Hollywood J, Jayne D, Lima M, Maharaj A, Mallen C, Martinez-Taboada V, Maz M, Merry S, Miller J, Mori S, Neill L, Nordborg E, Nott J, Padbury H, Pease C, Salvarani C, Schirmer M, Schmidt W, Spiera R, Tronnier D, Wagner A, Whitlock M, Matteson EL, Dasgupta B, European League Against Rheumatism, American College of Rheumatology. 2015 recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheum. 2015;67(10):2569–80. doi:10.1002/art.39333.

    Article  Google Scholar 

  5. Dasgupta B, Borg FA, Hassan N, et al. BSR and BHPR guidelines for the management of polymyalgia rheumatic. Rheumatology. 2010;49:186–90. doi:10.1093/rheumatology/kep303a.

    Article  PubMed  Google Scholar 

  6. Salvarani C, Cantini F, Boiardi L, et al. Polymyalgia rheumatica and giant cell arteritis. N Engl J Med. 2002;347:261–71.

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  8. Woolf AD. An update on glucocorticoid-induced osteoporosis. Curr Opin Rheumatol. 2007;19(4):370–5.

    CAS  PubMed  Google Scholar 

  9. Leeb BF, Rintelen B, Sautner J, Fassl C, Bird HA. The Polymyalgia Rheumatica Activity Score (PMR-AS) in daily use—proposal for a definition of remission. Arthritis Rheum. 2007;57(5):810–5.

    Article  PubMed  Google Scholar 

  10. De Silva M, Hazleman BL. Azathioprine in giant cell arteritis/polymyalgia rheumatica: a double-blind study. Ann Rheum Dis. 1986;45(2):136–8.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Mahr AD, Jover JA, Spiera RF, Hernández-García C, Fernández-Gutiérrez B, Lavalley MP, Merkel PA. Adjunctive methotrexate for treatment of giant cell arteritis: an individual patient data meta-analysis. Arthritis Rheum. 2007;56(8):2789–97.

    Article  CAS  PubMed  Google Scholar 

  12. de Boysson H, Boutemy J, Creveuil C, Ollivier Y, Letellier P, Pagnoux C, Bienvenu B. Is there a place for cyclophosphamide in the treatment of giant-cell arteritis? A case series and systematic review. Semin Arthritis Rheum. 2013;43(1):105–12. doi:10.1016/j.semarthrit.2012.12.023. Epub 2013 Feb 27.

    Article  PubMed  Google Scholar 

  13. Doury P, Pattin S, Eulry F, Thabaut A. The use of dapsone in the treatment of giant cell arteritis and polymyalgia rheumatica. Arthritis Rheum. 1983;26(5):689–90.

    Article  CAS  PubMed  Google Scholar 

  14. Ly KH, Régent A, Tamby MC, Mouthon L. Pathogenesis of giant cell arteritis: more than just an inflammatory condition? Autoimmun Rev. 2010;9(10):635–45. doi:10.1016/j.autrev.2010.05.002. Epub 2010 May 8.

    Article  CAS  PubMed  Google Scholar 

  15. Hoffman GS, Cid MC, Rendt-Zagar KE, Merkel PA, Weyand CM, Stone JH, Salvarani C, Xu W, Visvanathan S, Rahman MU, Infliximab-GCA Study Group. Infliximab for maintenance of glucocorticosteroid-induced remission of giant cell arteritis: a randomized trial. Ann Intern Med. 2007;146(9):621–30.

    Article  PubMed  Google Scholar 

  16. Martínez-Taboada VM, Rodríguez-Valverde V, Carreño L, López-Longo J, Figueroa M, Belzunegui J, Mola EM, Bonilla G. A double-blind placebo controlled trial of etanercept in patients with giant cell arteritis and corticosteroid side effects. Ann Rheum Dis. 2008;67(5):625–30.

    Article  PubMed  Google Scholar 

  17. Salvarani C, Macchioni P, Manzini C, Paolazzi G, Trotta A, Manganelli P, Cimmino M, Gerli R, Catanoso MG, Boiardi L, Cantini F, Klersy C, Hunder GG. Infliximab plus prednisone or placebo plus prednisone for the initial treatment of polymyalgia rheumatica: a randomized trial. Ann Intern Med. 2007;146(9):631–9.

    Google Scholar 

  18. Leeb BF, Bird HA. A disease activity score for polymyalgia rheumatica—PMR-AS. Ann Rheum Dis. 2004;63:1279–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Kreiner F, Galbo H. Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial. Arthritis Res Ther. 2010;12(5):R176. doi:10.1186/ar3140. Epub 2010 Sep 20.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Salvarani C, Hunder GG. Tumor necrosis factor blocking agents in polymyalgia rheumatica and giant cell arteritis. Ann Intern Med. 2008;148(2):167–8.

    Article  PubMed  Google Scholar 

  21. Langford CA, Cuthbertson D, Ytterberg SR, Khalidi NA, et al. A randomized double-blind trial of abatacept and glucocorticoids for the treatment of giant cell arteritis. ACR 2015; Abstract Number: 9L.

    Google Scholar 

  22. Stone J, et al. Efficacy and safety of tocilizumab in patients with giant cell arteritis: week 52 results from a phase 3, multicenter, randomized, double-blind placebo-controlled trial. Presented at the 2016 American College of Rheumatology.

    Google Scholar 

  23. Devauchelle-Pensec V, Berthelot JM, Cornec D, Renaudineau Y, Marhadour T, Jousse-Joulin S, Querellou S, Garrigues F, De Bandt M, Gouillou M, Saraux A. Efficacy of first-line tocilizumab therapy in early polymyalgia rheumatica: a prospective longitudinal study. Ann Rheum Dis. 2016;75(8):1506–10. doi:10.1136/annrheumdis-2015-208742. Epub 2016 Feb 29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Villiger PM, Adler S, Kuchen S, Wermelinger F, Dan D, Fiege V, Bütikofer L, Seitz M, Reichenbach S. Tocilizumab for induction and maintenance of remission in giant cell arteritis: a phase 2, randomised, double-blind, placebo-controlled trial. Lancet. 2016;387(10031):1921–7. doi:10.1016/S0140-6736(16)00560-2. Epub 2016 Mar 4.

    Article  CAS  PubMed  Google Scholar 

  25. González-Gay MA, Pina T. Giant cell arteritis and polymyalgia rheumatica: an update. Curr Rheumatol Rep. 2015;17(2):6. doi:10.1007/s11926-014-0480-1.

    Article  PubMed  Google Scholar 

  26. Toussirot É, Régent A, Devauchelle-Pensec V, Saraux A, Puéchal X. Interleukin-6: a promising target for the treatment of polymyalgia rheumatica or giant cell arteritis? RMD Open. 2016;2(2):e000305.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Burkhard F. Leeb MD, PhD .

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Leeb, B.F. (2017). Biologicals: A Perspective for the Treatment of PMR/GCA. In: Rovenský, J., Leeb, B., Štvrtinová, V., Imrich, R. (eds) Polymyalgia Rheumatica and Giant Cell Arteritis. Springer, Cham. https://doi.org/10.1007/978-3-319-52222-7_12

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  • DOI: https://doi.org/10.1007/978-3-319-52222-7_12

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