Tocilizumab in the treatment of polymyalgia rheumatica – a case report
Authors:
P. Němec 1; Šprláková Puková; A 2; Z. Řehák 3
Authors place of work:
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 the journal:
Čes. Revmatol., 26, 2018, No. 2, p. 88-98.
Category:
Case Report
Summary
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
Zdroje
1. Smeeth L, Cook C, Hall AJ. Incidence of diagnosed polymyalgia rheumatica and temporal arteritis in the United Kingdom, 1990–2001. Ann Rheum Dis 2006 ;65(8): 1093 – 8.
2. Rooney PJ, Rooney J, Balint G, et al. Polymyalgia rheumatica: 125 years of epidemiological progress? Scott Med J 2015; 60(1): 50–7.
3. Sonnenblick M, Nesher G, Friedlander Y, et al. Giant cell arteritis in Jerusalem: a 12 year epidemiological study. Br J Rheumatol 1994; 33(10): 938–41.
4. Salvarani C, Gabriel SE, O‘Fallon WM, et al. Epidemiology of polymyalgia rheumatica in Olmsted County, Minnesota, 1970–1991. Arthritis Rheum 1995; 38(3): 369–73.
5. Gonzalez-Gay MA, Vasquez-Rodriguez TR, Lopez-Diaz MJ, et al. Epidemiology of giant cell arteritis and polymyalgia rheumatica. Arthritis Rheum (Arthritis Care Res) 2009; 61: 1454–61.
6. Salvarani C, Cantini F, Boiardi L, et al. Polymyalgia rheumatica and giant cell arteritis. New Eng J Med 2002; 347: 261–267.
7. Ross RT. From the Tadhkirat of Ali Ibn Isa of Baghdad (c 940–1010 AD)–an ancient description of what may be temporal arteritis. J Neurol Neurosurg Psychiatry 1988; 51: 528.
8. Calvo-Romero JM. Giant cell arteritis. Postgrad Med J 2003; 79: 511–15.
9. Gonzalez-Gay MA. Genetic epidemiology. Giant cell arteritis and polymyalgia rheumatica. Arthritis Res 2001; 3(3): 154–7.
10. Dasgupta B, Cimmino MA, Maradit-Kremers H, et al. 2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 2012; 71(4): 484–92.
11. Leeb BF, Bird HA. A disease activity score for polymyalgia rheumatica. Ann Rheum Dis 2004; 63(10): 1279–83.
12. Leeb BF, Rintelen B, Sautner J, Fassl C, et al. The polymyalgia rheumatica activity score in daily use: proposal for a definition of remission. Arthritis Rheum 2007;57(5):810-5.
13. Dejaco C, Singh YP, Perel P, et al. 2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 2015; 74(10): 1799–807.
14. Duru N, van der Goes MC, Jacobs JWG, et al. EULAR evidence-based and consensus-based recommendations on the management of medium to high-dose glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis 2013; 72: 1905–13.
15. Grossman JM, Gordon R, Ranganath VK, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken) 2010; 62: 151 5– 26.
16. Van der Goes MC, Jacobs JWG, Boers M, et al. Monitoring adverse events of low-dose glucocorticoid therapy: EULAR recommendations for clinical trials and daily practice. Ann Rheum Dis 2010; 69: 1913–19.
17. Hoes JN, Jacobs JWG, Boers M, et al. EULAR evidence-based recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases. Ann Rheum Dis. 2007; 66: 1560–7.
18. Dasgupta B, Dolan AL, Panayi GS, et al. An initially double-blind controlled 96 week trial of depot methylprednisolone against oral prednisolone in the treatment of polymyalgia rheumatica. Br J Rheumatol 1998; 37: 189–95.
19. 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.
20. Recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis: 2001 update. American College of Rheumatology Ad Hoc Committee on Glucocorticoid-Induced Osteoporosis. Arthritis Rheum. 2001; 44(7): 1496–503.
21. Adler RA, Hochberg MC. Suggested guidelines for evaluation and treatment of glucocorticoid-induced osteoporosis for the Department of Veterans Affairs. Arch Intern Med 2003; 163(21): 2619–24.
22. Geusens PP, de Nijs RN, Lems WF, et al. Prevention of glucocorticoid osteoporosis: a consensus document of the Dutch Society for Rheumatology. Ann Rheum Dis 2004; 63(3): 324–5.
23. Briot K, Cortet B, Roux C, et al. 2014 update of recommendations on the prevention and treatment of glucocorticoid-induced osteoporosis. Joint Bone Spine 2014; 81(6): 493–501.
24. Devogelaer JP, Goemaere S, Boonen S, et al. Evidence-based guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis: a consensus document of the Belgian Bone Club. Osteoporos Int 2006; 17(1): 8–19.
25. Nawata H, Soen S, Takayanagi R, et al. Guidelines on the management and treatment of glucocorticoid-induced osteoporosis of the Japanese Society for Bone and Mineral Research (2004). J Bone Miner Metab 2005; 23(2): 105–9.
26. Grossman JM, Gordon R, Ranganath VK, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res (Hoboken) 2010; 62(11): 1515–26.
27. Ringe JD, Dorst A, Faber H, et al. Superiority of alfacalcidol over plain vitamin D in the treatment of glucocorticoid-induced osteoporosis. Rheumatol Int 2004; 24(2): 63–70.
28. Saag KG, Emkey R, Schnitzer TJ, Brown JP, Hawkins F, Goemaere S et al. Alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis. N Engl J Med 1998; 339(5): 292–9.
29. Cohen S, Levy RM, Keller M, Boling E, Emkey RD, Greenwald M et al. Risedronate therapy prevents corticosteroid-induced bone loss: a twelve-month, multicenter, randomized, double-blind, placebo-controlled, parallel-group study. Arthritis Rheum 1999; 42(11): 2309–18.
30. Wallach S, Cohen S, Reid DM, Hughes RA, Hosking DJ, Laan RF et al. Effects of risedronate treatment on bone density and vertebral fracture in patients on corticosteroid therapy. Calcif Tissue Int 2000; 67(4): 277–85.
31. Black DM, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA et al. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med 2007; 356(18): 1809–22.
32. Lyles KW, Colón-Emeric CS, Magaziner JS, Adachi JD, Pieper CF, Mautalen C et al. Zoledronic acid in reducing clinical fracture and mortality after hip fracture. N Engl J Med 2007; 357: 1799–809.
33. Reid DM, Devogelaer JP, Saag K, et al. Zoledronic acid and risedronate in the prevention and treatment of glucocorticoid-induced osteoporosis (HORIZON): a multicentre, double-blind, double-dummy, randomised controlled trial. Lancet 2009; 373(9671): 1253–63.
34. Saag KG, Shane E, Boonen S, et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med 2007; 357(20): 2028–39.
35. Saag KG, Zanchetta JR, Devogelaer JP, et al. Effects of teriparatide versus alendronate for treating glucocorticoid-induced osteoporosis: thirty-six-month results of a randomized, double-blind, controlled trial. Arthritis Rheum 2009; 60(11): 3346–55.
36. Langdahl BL, Marin F, Shane E, et al. Teriparatide versus alendronate for treating glucorticoid-induced osteoporosis: an analysis by gender and menopausal status. Osteoporosis Int 2009; 20(12): 2095–104.
37. González-Gay MA, Garcia-Porrua C, Vazquez-Caruncho M, et al. The spectrum of polymyalgia rheumatica in north western Spain: incidence and analysis of variables associated with relapse in a 10 year study. J Rheumatol 1999; 26(6): 1326–32.
38. Narváez J, Nolla-Sole JM, Clavaguera MT, et al. Long-term therapy in polymyalgia rheumatica: effect of coexistent temporal arteritis. J Rheumatol 1999; 26(9): 1945–1952.
39. Hutchings A, Hollywood J, Lamping DL, et al. Clinical outcomes, quality of life, and diagnostic uncertainty in the first year of polymyalgia rheumatica. Arthritis Rheum 2007; 57(5): 803–9.
40+. Kremers HM, Reinalda MS, Crowson CS, et al. Relapse in a population based cohort of patients with polymyalgia rheumatica. J Rheumatol 2005; 32(1): 65–73.
41. +Myklebust G, Gran JT. Prednisolone maintenance dose in relation to starting dose in the treatment of polymyalgia rheumatica and temporal arteritis: a prospective two-year study in 273 patients. Scand J Rheumatol 2001; 30(5): 260–7.
42. +Cimmino MA, Parodi M, Caporali R, et al. Is the course of steroid-treated polymyalgia rheumatica more severe in women? Ann N Y Acad Sci 2006; 1069: 315–21.
43. +Dasgupta B, Dolan AL, Panayi GS, et al. An initially double-blind controlled 96-week trial of depot methylprednisolone against oral prednisolone in the treatment of polymyalgia rheumatica. Br J Rheumatol 1998; 37(2): 189-95.
44. Caporali R, Cimmino MA, Ferraccioli G, et al. Prednisone plus methotrexate for polymyalgia rheumatica: a randomized, double-blind, placebo-controlled trial. Ann Intern Med 2004; 141: 493–500.
45. Van der Veen MJ, Dinant HJ, van Booma-Frankfort C, et al. Can methotrexate be used as a steroid sparing agent in the treatment of polymyalgia rheumatica and giant cell arteritis? Ann Rheum Dis 1996;55: 218–23.
46. Ferraccioli G, Salaffi F, De Vita S, et al. Methotrexate in polymyalgia rheumatica: preliminary results of an open, randomized study. J Rheumatol 1996; 23: 624–8.
47. Nazarinia AM, Moghimi J, Toussi J. Efficacy of methotrexate in patients with polymyalgia rheumatica. Koomesh 2012; 14: 265–70.
48. Kreiner F, Galbo H. Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial. Arthritis Res Ther 2010; 12(5): R176.
49. 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(3): 575–9.
50. Bejerano C, Blanco R, González-Vela C, et al. Refractory polymyalgia rheumatica as presenting manifestation of large-vessel vasculitis associated to sarcoidosis. Successful response to adalimumab. Clin Exp Rheumatol 2012; 30(1 Suppl 70): S94–7.
51. Langford CA, Cuthbertson D, Ytterberg SR, et al. A Randomized, Double-Blind Trial of Abatacept (CTLA-4Ig) for the Treatment of Giant Cell Arteritis. Arthritis Rheumatol 2017; 69(4): 837–45.
52. Conway R, O‘Neill L, O‘Flynn E, et al. Ustekinumab for the treatment of refractory giant cell arteritis. Ann Rheum Dis 2016; 75(8): 1578–9.
53. Samson M, Espígol-Frigolé G, Terrades-García N, et al. Biological treatments in giant cell arteritis & Takayasu arteritis. Eur J Intern Med. 2018; 50: 12–9.
54. Martinez-Taboada VM, Alvarez L, RuizSoto M et al. Giant cell arteritis and poylymalgia rheumatica: role of cytokines in the pathogenesis and implication for treatment. Cytokine 2008; 44: 207–20.
55. Naka T, Nishimoto N, Kishimoto T. The paradigm of OL-6 from basic science to medicine. Arthritis Re. 2002; 4(Suppl 3): S233–42.
56. Narazaki M, Yasukawa K, Saito T et al. Soluble forms of the interleukin-6 signal-transducing receptor component gp130 in human serum possessing a potential to inhibit signals through membrane-anchored gp130. Blood 1993; 82: 1120–6.
57. Tanaka T, Narazaki M, Kishimoto T. Anti-interleukin-6 receptor antibody, tocilizumab, for the treatment of autoimmune diseases. FEBS Letters 2011; 585(23): 3699–709.
58. Stone JH, Tuckwel K, Dimonaco S, et al. Trial of tocilizumab in Giant-cell arteritis. NEJM 2017; 377(4): 317–28.
59. Hagihara K, Kawase I, Tanaka T et al. Tocilizumab ameliorates clinical symptoms in polymyalgia rheumatica. J Rheumatol 2010; 37: 1075–6.
60. Christidis D, Jain S, Das Gupta B. Successful use of tocilizumab in polymyalgic onset biopsy positive GCA with large vessel involvement. BMJ Case Rep 2011; 2011: pii:bcr0420114135.
61. 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.
62. Macchioni P, Boiardi L, Catanoso M et al. Tocilizumab for polymyalgia rheumatica: report of two cases and review of the literature. Semin Arthritis Rheum 2013; 43: 113–18.
63. Al Rashidi A, Hegazi MO, Mohammad SA et al. Effective control of polymyalgia rheumatica with tocilizumab. J Clin Rheumatol 2013; 19: 400–1.
64. Mori S, Koga Y. Glucocorticoid-resistant polymyalgia rheumatica: pretreatment characteristics and tocilizumab therapy. Clin Rheumatol 2016; 35(5): 1367–75.
65. Devauchelle V, Berthelot JM, Cornec D, et al. FRI0280 Efficacy and Safety of Tocilizumab as First Line Therapy in Patients with Recent Polymyalgia Rheumatica (PMR): Results of the First Longitudinal Prospective Study (Tenor). Ann Rheum Dis 2015; 74: 526.
66. Lally L, Forbess L, Hatzis C, et al. Brief Report: A Prospective Open-Label Phase IIa Trial of Tocilizumab in the Treatment of Polymyalgia Rheumatica. Arthritis Rheumatol 2016; 68(10): 2550–4.
67. Uchiyama Y, Yoshida H, Koike N, et al. Anti-IL-6 receptor antibody increases blood IL-6 level via the blockade of IL-6 clearance, but not via the induction of IL-6 production. Int Immunopharmacol 2008; 8(11): 1595–601
Štítky
Dermatology & STDs Paediatric rheumatology RheumatologyČlánok vyšiel v časopise
Czech Rheumatology
2018 Číslo 2
Najčítanejšie v tomto čísle
- Polymyalgia rheumatica as a complication of immune checkpoint inhibitors treatment due to malignant melanoma
- Fertility and rheumatic diseases
- Tocilizumab in the treatment of polymyalgia rheumatica – a case report
- Pyoderma gangrenosum and necrotizing arteritis in elderly onset rheumatoid arthritis – a case study