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Direct interleukin-6 inhibitor olokizumab in the treatment of polymyalgia rheumatica: a case series

Alexey D Meshkov1, Alexey L Maslyanskiy2, Anton L Chudinov3

  • 1Russian Clinical and Research Center of Gerontology, Moscow, Russia.

Frontiers in Medicine
|June 11, 2026
PubMed
Abstract

Insights

Olokizumab effectively reduced polymyalgia rheumatica (PMR) activity and inflammation markers in patients intolerant to methotrexate. This steroid-sparing therapy achieved remission or low disease activity in most participants.

Area of Science:

  • Rheumatology
  • Immunology
  • Clinical Pharmacology

Background:

  • Polymyalgia rheumatica (PMR) often requires steroid-sparing therapy due to methotrexate (MTX) intolerance or inadequate response.
  • Olokizumab (OKZ) is an IL-6 inhibitor investigated for its potential in managing autoimmune conditions.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of olokizumab in PMR patients with contraindications or poor response to methotrexate.
  • To assess OKZ as a steroid-sparing agent in this specific patient cohort.

Main Methods:

  • A case series of 23 PMR patients (9 with giant-cell arteritis) treated with OKZ.
  • Disease activity assessed via PMR-Activity Score (AS) and inflammatory markers (ESR, CRP).
  • Statistical analysis performed using StatTech v. 4.7.3.

Main Results:

  • Olokizumab significantly reduced PMR-AS scores (18.6 to 3.01) and inflammatory markers (ESR, CRP) by weeks 12-24 (p < 0.05).
  • 86.3% of patients achieved remission or low disease activity.
  • Average daily steroid dose decreased from 7.5 mg to 2.5 mg by week 24.
  • Disease duration < 36 months predicted low PMR activity (AUC = 0.912, p = 0.024).

Conclusions:

  • Olokizumab demonstrates high efficacy in reducing PMR activity and inflammation.
  • OKZ serves as an effective steroid-sparing option for patients with methotrexate intolerance or failure.
Keywords:
IL-6 inhibitioncorticosteroidsgiant cell arteritisolokizumabpolymyalgia rheumatica

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