Tumor Necrosis Factor–Blocking Agents in Polymyalgia Rheumatica and Giant Cell Arteritis
Authors: Carlo Salvarani, Gene G. Hunder
Journal: Annals of Internal Medicine (2008)

Letters15 January 2008Tumor Necrosis Factor–Blocking Agents in Polymyalgia Rheumatica and Giant Cell ArteritisCarlo Salvarani, MD and Gene G. HunderCarlo Salvarani, MDFrom Arcispedale S. Maria Nuova, Reggio Emilia, 42100, Italy; and Mayo Clinic, Rochester, MN 55905.Search for more papers by this author and Gene G. HunderFrom Arcispedale S. Maria Nuova, Reggio Emilia, 42100, Italy; and Mayo Clinic, Rochester, MN 55905.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-2-200801150-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We agree with the conclusions of the insightful editorial by Luqmani (1) about the 2 randomized, controlled trials (RCTs) of infliximab in polymyalgia rheumatica (2) and giant cell arteritis (GCA) (3), especially that corticosteroids are still the cornerstone of treatment for these 2 related diseases. However, although these 2 studies showed that adding infliximab to prednisone is of no benefit in patients with GCA or polymyalgia rheumatica, a corticosteroid-sparing effect for tumor necrosis factor (TNF) blockers in these 2 conditions cannot be completely excluded. As Luqmani pointed out, the 2 trials were designed to detect a large ...References1. Luqmani R. Treatment of polymyalgia rheumatica and giant cell arteritis: are we any further forward? [Editorial]. Ann Intern Med. 2007;146:674-6. [PMID: 17470835] LinkGoogle Scholar2. Hoffman GS, Cid MC, Rendt-Zagar KE, Merkel PA, Weyand CM, Stone JH, et al; Infliximab-GCA Study Group. Infliximab for maintenance of glucocorticosteroid-induced remission of giant cell arteritis: a randomized trial. Ann Intern Med. 2007;146:621-30. [PMID: 17470830] LinkGoogle Scholar3. Salvarani C, Macchioni P, Manzini C, Paolazzi G, Trotta A, Manganelli P, et al. Infliximab plus prednisone or placebo plus prednisone for the initial treatment of polymyalgia rheumatica: a randomized trial. Ann Intern Med. 2007;146:631-9. [PMID: 17470831] LinkGoogle Scholar4. Salvarani C, Cantini F, Niccoli L, Catanoso MG, Macchioni P, Pulsatelli L, et al. Treatment of refractory polymyalgia rheumatica with infliximab: a pilot study. J Rheumatol. 2003;30:760-3. [PMID: 12672196] MedlineGoogle Scholar5. Cantini F, Niccoli L, Salvarani C, Padula A, Olivieri I. Treatment of longstanding active giant cell arteritis with infliximab: report of four cases. Arthritis Rheum. 2001;44:2933-5. [PMID: 11762955] CrossrefMedlineGoogle Scholar6. Catanoso MG, Macchioni PL, Boiardi L, Pipitone N, Salvarani C. Treatment of refractory polymyalgia rheumatica with etanercept: an open pilot study. Arthritis Rheum. 2007;57:1514-9. CrossrefMedlineGoogle Scholar7. Hernández-Rodríguez J, Segarra M, Vilardell C, Sánchez M, García-Martínez A, Esteban MJ, et al. Tissue production of pro-inflammatory cytokines (IL-1beta, TNFalpha and IL-6) correlates with the intensity of the systemic inflammatory response and with corticosteroid requirements in giant-cell arteritis. Rheumatology (Oxford). 2004;43:294-301. [PMID: 14679293] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Arcispedale S. Maria Nuova, Reggio Emilia, 42100, Italy; and Mayo Clinic, Rochester, MN 55905.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoInfliximab for Maintenance of Glucocorticosteroid-Induced Remission of Giant Cell Arteritis Gary S. Hoffman , Maria C. Cid , Karen E. Rendt-Zagar , Peter A. Merkel , Cornelia M. Weyand , John H. Stone , Carlo Salvarani , Weichun Xu , Sudha Visvanathan , Mahboob U. Rahman , and Infliximab plus Prednisone or Placebo plus Prednisone for the Initial Treatment of Polymyalgia Rheumatica Carlo Salvarani , PierLuigi Macchioni , Carlo Manzini , Giuseppe Paolazzi , Aldo Trotta , Paolo Manganelli , Marco Cimmino , Roberto Gerli , Maria Grazia Catanoso , Luigi Boiardi , Fabrizio Cantini , Catherine Klersy , and Gene G. Hunder Treatment of Polymyalgia Rheumatica and Giant Cell Arteritis: Are We Any Further Forward? Raashid Luqmani Metrics Cited ByBiologicals: A Perspective for the Treatment of PMR/GCA 15 January 2008Volume 148, Issue 2Page: 167-168KeywordsAcute phase proteinsConflicts of interestCytokinesDrugsGiant cellsInterleukinsNecrosisPilot studiesPolymyalgia rheumatica ePublished: 15 January 2008 Issue Published: 15 January 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...