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Biological therapy in polymyalgia rheumatica.

Daniel Wendling1,2

  • 1Rheumatology, CHU (University Teaching Hospital), Besançon, France.

Expert Opinion on Biological Therapy
|November 23, 2023
PubMed
Summary

Biological treatments, particularly anti-interleukin-6 agents, show promise for polymyalgia rheumatica (PMR). These therapies may reduce reliance on corticosteroids and their side effects in elderly patients.

Keywords:
Polymyalgia rheumaticaabataceptanti-TNFbiologic agentsrituximabsarilumabtocilizumabtreatment

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Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Polymyalgia rheumatica (PMR) is a common inflammatory condition in the elderly.
  • Systemic corticosteroids are the primary treatment but carry significant side effect risks in this population.
  • Comorbidities in elderly patients exacerbate steroid-related adverse events.

Purpose of the Study:

  • To review current literature on the efficacy and safety of biological treatments for PMR.
  • To evaluate the potential of biologic therapies as alternatives or adjuncts to corticosteroids.
  • To identify promising biologic agents for PMR management.

Main Methods:

  • Literature search of PubMed and clinical trial databases.
  • Analysis of studies reporting on the use of biological agents in PMR patients.
  • Assessment of treatment efficacy and safety profiles.

Main Results:

  • Anti-tumor necrosis factor (TNF) agents have not demonstrated clear efficacy in PMR.
  • Anti-interleukin-6 (IL-6) agents (tocilizumab, sarilumab) show consistent efficacy.
  • Anti-IL-6 therapies offer a notable steroid-sparing effect and acceptable safety in PMR patients.

Conclusions:

  • Anti-IL-6 agents represent a valuable therapeutic option for polymyalgia rheumatica.
  • These agents are particularly beneficial for patients with steroid-resistant disease or high risk of corticosteroid complications.
  • Further evaluation of other targeted biologic treatments is ongoing.