Polymyalgia rheumatica (PMR) affects older people, and although
glucocorticoids are effective in treating PMR, they frequently result in side effects. Therefore, we conducted a retrospective study to assess the effectiveness and safety of
tocilizumab as an alternative to
glucocorticoids. We included 13 consecutive patients with PMR (11 women and 2 men; median age, 74 years) diagnosed according to Bird's criteria and the 2012 European League Against
Rheumatism/American College of Rheumatology provisional classification criteria. All patients received
tocilizumab infusion (8 mg/kg every 4 weeks) at our institutions, between 2008 and 2014, because of PMR relapses (n=12) or insufficient response to initial
prednisolone treatment (n=1), without increasing
prednisolone dosage. Seven patients were on
methotrexate, and all had one or more
glucocorticoid-related comorbidities. Administration of
tocilizumab significantly improved
inflammation and PMR symptoms such as morning stiffness, as well as the Patient-
Pain and Patient-Global Assessment visual analogue scales (p<0.05). Proximal
muscle pain disappeared within 8 weeks, on average, and the Health Assessment Questionnaire-Disability Index scores (p=0.098) and concomitant
prednisolone doses (p<0.05) decreased at 12 weeks. Severe adverse events were not observed during the mean
tocilizumab treatment period of 43.4 weeks. Our findings suggest that
tocilizumab is effective and safe for PMR treatment.