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TNF-alpha blockade induce clinical remission in patients affected by polymyalgia rheumatica associated to diabetes mellitus and/or osteoporosis: a seven cases report.

Abstract
Polymyalgia rheumatica (PMR) is a chronic inflammatory condition of the elderly, characterized by aching and morning stiffness in the cervical region, shoulders and pelvic girdles. A steroid treatment course of 6-24 months is often required, but, due to important side effects, it is troublesome if the PMR patient is also affected by diabetes mellitus (DM) and/or osteoporosis. Aim of our study is to test anti-TNF alpha treatment as a steroid sparing tool in PMR patients affected by DM or osteoporosis. In particular, we hypothesise that TNF alpha blockade can be useful not only in remission maintaining, but also in the induction of clinical remission without corticosteroids in this kind of patients. In a six months follow up, patients had clinical improvement, confirmed by physical medical examination, and a statistically significant reduction in ESR and CRP mean values. Anti-TNF alpha treatment was well tolerated by all patients. These preliminary data suggest than Infliximab can be useful in the treatment of PMR patients, not only for steroid sparing purposes, but also as first line therapy in PMR patients with severe comorbidity, such as diabetes mellitus or osteoporosis.
AuthorsA Migliore, U Massafra, E Carloni, C Padalino, S Martin Martin, F Lasaracina, N Dibiase, A Alimonti, M Granata
JournalEuropean review for medical and pharmacological sciences (Eur Rev Med Pharmacol Sci) 2005 Nov-Dec Vol. 9 Issue 6 Pg. 373-8 ISSN: 1128-3602 [Print] Italy
PMID16479743 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • Tumor Necrosis Factor-alpha
  • Infliximab
Topics
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal (therapeutic use)
  • Antirheumatic Agents (therapeutic use)
  • Diabetes Mellitus, Type 1 (complications)
  • Diabetes Mellitus, Type 2 (complications)
  • Female
  • Humans
  • Infliximab
  • Osteoporosis (complications)
  • Polymyalgia Rheumatica (complications, drug therapy)
  • Remission Induction
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha (antagonists & inhibitors, immunology)

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