Abstract
Objective. To investigate whether infliximab has a steroid-sparing effect in the treatment of patients with polymyalgia rheumatica (PMR) who are resistant to corticosteroid (CS) therapy and have had CS-related side effects. Methods. In a pilot study, infliximab 3 mg/kg was administered at weeks 0, 2, and 6 in 4 patients with relapsing PMR who were not able to reduce their prednisone dose below 7.5-12.5 mg/day and who had experienced multiple vertebral fractures. The patients were regularly monitored for clinical signs/symptoms and erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) during the one-year followup period. Results. Two patients had a complete response to infliximab with clinical remission 2 weeks after the first infusion. At this time ESR and IL-6 values were normal and the patients were able to suspend prednisone. Normal ESR, CRP, and IL-6 levels persisted after the suspension of infliximab and prednisone during the followup period, paralleling the clinical remission. The third patient had a complete and persistent clinical remission 2 weeks after the first infusion, although IL-6 levels remained elevated during the followup period despite the normalization of ESR values. These 3 patients were symptom-free with normal ESR and CRP at the end of 1-year of followup. The fourth patient had continuous clinical activity associated with persistently elevated acute phase reactants, although IL-6 levels measured during followup were lower compared to baseline values and the patient was able to reduce prednisone dosage to 5 mg/day. Conclusion. Our encouraging results suggest that a controlled study may assess the efficacy of infliximab as CS-sparing drug in PMR.
| Original language | English |
|---|---|
| Pages (from-to) | 760-763 |
| Number of pages | 4 |
| Journal | Journal of Rheumatology |
| Volume | 30 |
| Issue number | 4 |
| Publication status | Published - Apr 1 2003 |
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Keywords
- Infliximab
- Polymyalgia rheumatica
- Relapsing disease
ASJC Scopus subject areas
- Rheumatology
- Immunology
Cite this
Treatment of refractory polymyalgia rheumatica with infliximab : A pilot study. / Salvarani, Carlo; Cantini, Fabrizio; Niccoli, Laura; Catanoso, Maria Grazia; Macchioni, Pierluigi; Pulsatelli, Lia; Padula, Angela; Olivieri, Ignazio; Boiardi, Luigi.
In: Journal of Rheumatology, Vol. 30, No. 4, 01.04.2003, p. 760-763.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment of refractory polymyalgia rheumatica with infliximab
T2 - A pilot study
AU - Salvarani, Carlo
AU - Cantini, Fabrizio
AU - Niccoli, Laura
AU - Catanoso, Maria Grazia
AU - Macchioni, Pierluigi
AU - Pulsatelli, Lia
AU - Padula, Angela
AU - Olivieri, Ignazio
AU - Boiardi, Luigi
PY - 2003/4/1
Y1 - 2003/4/1
N2 - Objective. To investigate whether infliximab has a steroid-sparing effect in the treatment of patients with polymyalgia rheumatica (PMR) who are resistant to corticosteroid (CS) therapy and have had CS-related side effects. Methods. In a pilot study, infliximab 3 mg/kg was administered at weeks 0, 2, and 6 in 4 patients with relapsing PMR who were not able to reduce their prednisone dose below 7.5-12.5 mg/day and who had experienced multiple vertebral fractures. The patients were regularly monitored for clinical signs/symptoms and erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) during the one-year followup period. Results. Two patients had a complete response to infliximab with clinical remission 2 weeks after the first infusion. At this time ESR and IL-6 values were normal and the patients were able to suspend prednisone. Normal ESR, CRP, and IL-6 levels persisted after the suspension of infliximab and prednisone during the followup period, paralleling the clinical remission. The third patient had a complete and persistent clinical remission 2 weeks after the first infusion, although IL-6 levels remained elevated during the followup period despite the normalization of ESR values. These 3 patients were symptom-free with normal ESR and CRP at the end of 1-year of followup. The fourth patient had continuous clinical activity associated with persistently elevated acute phase reactants, although IL-6 levels measured during followup were lower compared to baseline values and the patient was able to reduce prednisone dosage to 5 mg/day. Conclusion. Our encouraging results suggest that a controlled study may assess the efficacy of infliximab as CS-sparing drug in PMR.
AB - Objective. To investigate whether infliximab has a steroid-sparing effect in the treatment of patients with polymyalgia rheumatica (PMR) who are resistant to corticosteroid (CS) therapy and have had CS-related side effects. Methods. In a pilot study, infliximab 3 mg/kg was administered at weeks 0, 2, and 6 in 4 patients with relapsing PMR who were not able to reduce their prednisone dose below 7.5-12.5 mg/day and who had experienced multiple vertebral fractures. The patients were regularly monitored for clinical signs/symptoms and erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) during the one-year followup period. Results. Two patients had a complete response to infliximab with clinical remission 2 weeks after the first infusion. At this time ESR and IL-6 values were normal and the patients were able to suspend prednisone. Normal ESR, CRP, and IL-6 levels persisted after the suspension of infliximab and prednisone during the followup period, paralleling the clinical remission. The third patient had a complete and persistent clinical remission 2 weeks after the first infusion, although IL-6 levels remained elevated during the followup period despite the normalization of ESR values. These 3 patients were symptom-free with normal ESR and CRP at the end of 1-year of followup. The fourth patient had continuous clinical activity associated with persistently elevated acute phase reactants, although IL-6 levels measured during followup were lower compared to baseline values and the patient was able to reduce prednisone dosage to 5 mg/day. Conclusion. Our encouraging results suggest that a controlled study may assess the efficacy of infliximab as CS-sparing drug in PMR.
KW - Infliximab
KW - Polymyalgia rheumatica
KW - Relapsing disease
UR - http://www.scopus.com/inward/record.url?scp=12444282780&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=12444282780&partnerID=8YFLogxK
M3 - Article
C2 - 12672196
AN - SCOPUS:12444282780
VL - 30
SP - 760
EP - 763
JO - Journal of Rheumatology
JF - Journal of Rheumatology
SN - 0315-162X
IS - 4
ER -