Effective Control of Polymyalgia Rheumatica With Tocilizumab

Rashidi, Abdulrahman Al; Hegazi, Mohamed Osama; Mohammad, Shaimaa Abdelsattar; Varghese, Alex

doi:10.1097/rhu.0b013e3182a6aa0e

Cited by 21 publications

(13 citation statements)

References 10 publications

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“…Seven similar cases of pure PMR treated by TCZ have previously been reported 7,8,9,10 , while a substantially higher number of patients with GCA have received this biological agent 4,5 . In PMR cases, TCZ was given as a monthly 8 mg/kg infusion with a clinical response observed within 4 to 12 weeks.…”

Section: To the Editormentioning

confidence: 81%

Rapid and Sustained Response to Tocilizumab in Patients with Polymyalgia Rheumatica Resistant or Intolerant to Glucocorticoids: A Multicenter Open-label Study

Toussirot

Martin

Soubrier³

et al. 2016

J Rheumatol

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Section: To the Editormentioning

confidence: 81%

Rapid and Sustained Response to Tocilizumab in Patients with Polymyalgia Rheumatica Resistant or Intolerant to Glucocorticoids: A Multicenter Open-label Study

Toussirot

Martin

Soubrier³

et al. 2016

J Rheumatol

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“…A number of studies have reported high serum levels of interleukin (IL)‐6 in patients with PMR, suggesting that IL‐6 may play a crucial role in the pathogenesis of this condition. In addition, many case reports have confirmed that tocilizumab (TCZ), a humanized anti‐IL‐6 receptor antibody, is an effective treatment for PMR or giant cell arteritis with PMR, including patients who were treated with TCZ monotherapy . Recently, the GiACTA study reported the efficacy of TCZ on the induction of remission and GC‐sparing effect on patients with giant cell arteritis, and this study also revealed the possibility of the maintenance of remission induced by TCZ monotherapy after the discontinuation of GCs .…”

Section: Introductionmentioning

confidence: 83%

Tocilizumab monotherapy for polymyalgia rheumatica: A prospective, single‐center, open‐label study

et al. 2019

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| INTRODUC TI ONPolymyalgia rheumatica (PMR) is a systemic inflammatory disease of unknown etiology. It mainly affects elderly people and rarely arises in people younger than 50 years old. Typical clinical features of PMR include proximal myalgia (particularly in the shoulder girdles), morning stiffness of the trunk, and elevated erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) levels. 1,2 Glucocorticoids (GC) remain the mainstay therapy for PMR 2,3 because they produce dramatic responses in most patients. However, approximately half of patients with PMR experience relapse after tapering of the GC dose. 2,4 Moreover, long-term GC therapy can produce substantial adverse events, such as osteoporotic compression fractures of the spine, diabetes, infections and cardio-cerebral vascular events. 2,5,6 Abstract Objectives: Polymyalgia rheumatica (PMR) is a systemic inflammatory disease in the elderly of unknown etiology. While glucocorticoids are the mainstay of treatment for PMR, various glucocorticoid-related adverse events are common. Recently, several studies have reported the efficacy of tocilizumab (TCZ), an anti-interleukin-6 receptor antibody, for PMR treatment in addition to an accompanying reduction, or even tapering-off, of glucocorticoids in some cases. The objective of this study was to elucidate the efficacy of TCZ monotherapy in the absence of glucocorticoids for PMR. Method:We conducted a 2-year, prospective, single-center, open-label pilot study of TCZ monotherapy in patients with PMR. TCZ (8 mg/kg) was administered at fortnightly intervals for the first 2 months and monthly over the next 10 months.Subsequently, patients were observed for another year without any treatment. The primary endpoints were the remission rates at weeks 12 and 52, and the secondary endpoints were the relapse rate and safety over the total 104 weeks.Results: Thirteen patients were included in this study. Four of these patients achieved remission at week 12 (remission rate 31%). Four patients withdrew from the study due to adverse events (n = 2) and inefficacy (n = 2). At week 52, all 9 patients who had completed the first year achieved remission. Eight patients completed the drug-free second year, with 7 maintaining remission.Conclusions: TCZ monotherapy is well tolerated and can lead to remission in most patients with PMR in the absence of glucocorticoids. K E Y W O R D Sglucocorticoid, interleukin-6, monotherapy, polymyalgia rheumatica, tocilizumab agents. We used 15 infusions of TCZ. However, if fewer TCZ infusions are sufficient to control PMR and TCZ treatment could be ceased, then these cost problems would be negated. Therefore, the optimal number of infusions of TCZ required to control PMR activity must be determined in the future. In addition, as TCZ monotherapy is expected to reduce adverse events related to GCs, such as osteoporosis, diabetes, dyslipidemia, and so on, the additional costs associated with the treatment of these adverse events will be reduced.Several limitations of our study warran...

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“…Tocilizumab, used in a few cases thus far,67 68 is currently being studied in a phase 2 trial (clinicaltrials.gov NCT01396317) and results of a study comparing secukinumab, canakinumab and GCs (clinicaltrials.gov NCT01364389) will be available soon.…”

Section: Discussionmentioning

confidence: 99%

Current evidence for therapeutic interventions and prognostic factors in polymyalgia rheumatica: a systematic literature review informing the 2015 European League Against Rheumatism/American College of Rheumatology recommendations for the management of polymyalgia rheumatica

et al. 2015

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Effective Control of Polymyalgia Rheumatica With Tocilizumab

Cited by 21 publications

References 10 publications

Rapid and Sustained Response to Tocilizumab in Patients with Polymyalgia Rheumatica Resistant or Intolerant to Glucocorticoids: A Multicenter Open-label Study

Rapid and Sustained Response to Tocilizumab in Patients with Polymyalgia Rheumatica Resistant or Intolerant to Glucocorticoids: A Multicenter Open-label Study

Tocilizumab monotherapy for polymyalgia rheumatica: A prospective, single‐center, open‐label study

Current evidence for therapeutic interventions and prognostic factors in polymyalgia rheumatica: a systematic literature review informing the 2015 European League Against Rheumatism/American College of Rheumatology recommendations for the management of polymyalgia rheumatica

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