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Efficacy and Safety of Biologics in Polymyalgia Rheumatica: A Retrospective Study

Naoaki Ohkubo1, Yusuke Miyazaki1, Shingo Nakayamada1

  • 1The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahata-nishi, Kitakyushu, Fukuoka, 807-8555, Japan.

Rheumatology and Therapy
|August 9, 2024
PubMed
Abstract

Insights

Interleukin-6 receptor inhibitors (IL-6Ri) may effectively treat polymyalgia rheumatica (PMR) with rheumatoid arthritis (RA) complications. This study found IL-6Ri significantly reduced disease activity scores compared to other biological disease-modifying antirheumatic drugs (bDMARDs).

Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Polymyalgia rheumatica (PMR) can present with rheumatoid arthritis (RA) overlap.
  • Glucocorticoid resistance or intolerance is common in PMR/RA cases.
  • Biological disease-modifying antirheumatic drugs (bDMARDs) are used for complex PMR/RA.

Purpose of the Study:

  • To evaluate the efficacy and safety of bDMARDs in PMR patients with RA.
  • To compare different classes of bDMARDs for treating PMR/RA.
  • To identify factors influencing treatment outcomes in PMR/RA patients.

Main Methods:

  • Analysis of 203 patients with PMR/RA treated with bDMARDs.
  • Primary endpoint: Clinical Polymyalgia Rheumatica Activity Score (Clin-PMR-AS) at 26 weeks.
  • Secondary endpoint: Adverse events monitoring.
  • Comparison of tumor necrosis factor inhibitors (TNFi), IL-6 receptor inhibitors (IL-6Ri), and CTLA4-Ig.

Main Results:

  • IL-6Ri use was associated with significantly lower Clin-PMR-AS scores at 26 weeks.
  • Compared to TNFi (12.4) and CTLA4-Ig (15.9), IL-6Ri showed a lower mean Clin-PMR-AS (9.0).
  • Body mass index, prior bDMARD history, and IL-6Ri use were significant factors in Clin-PMR-AS.

Conclusions:

  • Interleukin-6 receptor inhibitors (IL-6Ri) demonstrate potential for improved disease activity in PMR/RA.
  • IL-6Ri may be a more effective bDMARD option for PMR patients with RA.
  • Further research into IL-6Ri for PMR/RA is warranted.
Keywords:
BiologicsIL-6 receptor inhibitorPolymyalgia rheumaticaRheumatoid arthritis

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