Fast recovery with etanercept in patients affected by polymyalgia rheumatica and decompensated diabetes: a case-series study

Corrao, Salvatore; Pistone, Giovanni; Scaglione, Rosario; Colomba, Daniela; Calvo, Luigi; Licata, Giuseppe

doi:10.1007/s10067-008-1026-6

Cited by 11 publications

(7 citation statements)

References 18 publications

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“…This discrepancy may reflect differences in study design or differences in mechanism of action of the two TNF-α antagonists. Arguing in favor of the latter possibility, in a small, uncontrolled study, it was demonstrated that etanercept was beneficial in the treatment of GC-treated patients with newly diagnosed PMR and decompensated diabetes [18]. However, arguing against the latter possibility, in line with our findings, infliximab monotherapy induced remission in a small, uncontrolled study with newly diagnosed patients with PMR [17].…”

Section: Discussionsupporting

confidence: 76%

“…Correspondingly, infliximab and etanercept have different therapeutic potentials in other diseases, for example, only infliximab is effective in granulomatosis disorders such as Crohn's disease and Wegener's granulomatosis [16]. Also, small uncontrolled studies have pointed to a beneficial effect of etanercept in patients with PMR [17,18]. Moreover, in a RCT of patients with giant cell arteritis (GCA), which is intimately related to PMR, etanercept was shown to be an effective therapy [19].…”

Section: Introductionmentioning

confidence: 99%

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Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial

Kreiner

Galbo

2010

Arthritis Res Ther

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IntroductionTo elucidate in polymyalgia rheumatica (PMR) the role of tumor necrosis factor (TNF) α and the therapeutic potential of blockade with soluble TNF-α receptor, we carried out the first randomized controlled trial with etanercept in PMR.MethodsTwenty newly diagnosed, glucocorticoid (GC) naïve patients with PMR and 20 matched non-PMR control subjects completed the trial. Subjects were randomized in a 1:1 ratio to monotherapy with etanercept (25 mg s.c. biweekly) or placebo (saline) for 14 days. Study outcomes were assessed at baseline and after 14 days. The primary outcome was the change in PMR activity score (PMR-AS). Secondary outcomes were: changes in erythrocyte sedimentation rate (ESR) and plasma levels of TNF-α and interleukin (IL) 6; patients' functional status (health assessment questionnaire) and cumulative tramadol intake during the trial.ResultsAt baseline, plasma TNF-α was higher in patients than in controls (P < 0.05). The concentration always increased with etanercept treatment (P < 0.05). In patients, etanercept decreased PMR-AS by 24% (P = 0.011), reflecting significant improvements in shoulder mobility, physician's global assessment and C-reactive protein, and insignificant (P > 0.05) improvements in duration of morning stiffness and patient's assessment of pain. In parallel, ESR and IL-6 were reduced (P < 0.05). Placebo treatment did not change PMR-AS, ESR and IL-6 (P > 0.05). Functional status did not change and tramadol intake did not differ between patient groups. In controls, no changes occurred in both groups.ConclusionsEtanercept monotherapy ameliorates disease activity in GC naïve patients with PMR. However, the effect is modest, indicating a minor role of TNF-α in PMR.Trial registrationClinicalTrials.gov (NCT00524381).

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial

Kreiner

Galbo

2010

Arthritis Res Ther

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“…Case series and disease cohorts of patients with PMR reveal a high incidence of glucocorticoid-related adverse events including osteoporosis, fracture, diabetes, weight gain, hypertension, diabetes, myocardial infarction and stroke (32)(33)(34)(35)(36)(37). This in itself is important for making treatment decisions regarding adjustment of GC therapy, or commencement steroid sparing therapy, in PMR.…”

Section: Glucocorticoid-related Adverse Events In Polymyalgia Rheumaticamentioning

confidence: 99%

Comorbidity in polymyalgia rheumatica

Chatzigeorgiou

McDermott

2018

Reumatismo

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Polymyalgia rheumatica (PMR) is the commonest inflammatory rheumatic disease affecting older people. The current mainstay of treatment is long-term oral glucocorticoid therapy. Management of these patients in clinical practice is often complicated by the presence of comorbidity. Comorbidity might be due to shared risk factors such as age, sex, or genetic background; to the presence of the disease itself; or to adverse effects of glucocorticoid therapy. Cardiovascular disease, osteoporosis/fracture, metabolic and ocular comorbidity are of particular interest to clinicians because of their relationship to glucocorticoid therapy and the relevance to clinical treatment decisions regarding glucocorticoid tapering. Patients at high risk of exacerbation of comorbidity by glucocorticoid therapy may be considered for adjunctive steroid-sparing therapies and thus may need specialist management. From a public health perspective, with the ageing population the prevalence of PMR is predicted to increase; accurate data on comorbidity will be needed for planning and delivery of healthcare services.

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“…Infliximab is used successfully for treatment of rheumatoid arthritis (Taylor et al, 2000), Crohn's disease (Kato et al, 2011) and diabetes (Corrao et al, 2009). Here, we demonstrate partial remission of SAVI disease in STING ki mice after systemic application of Infliximab.…”

Section: Introductionmentioning

confidence: 62%

Tissue inflammation induced by constitutively active STING is mediated by enhanced TNF signaling

Luksch,

Schulze,

Geißler-Lösch

et al. 2024

Preprint

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Constitutive activation of STING by gain-of-function mutations triggers manifestation of the systemic autoinflammatory disease STING-associated vasculopathy with onset in infancy (SAVI). In order to investigate the role of signaling by tumor necrosis factor (TNF) in SAVI, we used pharmacological inhibition and genetic inactivation of TNF receptors 1 and 2 in murine SAVI, which is characterized by T cell lymphopenia, inflammatory lung disease and neurodegeneration. Pharmacologic inhibition of TNF signaling improved T cell lymphopenia, but had no effect on interstitial lung disease. Genetic inactivation of TNFR1 and TNFR2, however, rescued the loss of thymocytes, reduced interstitial lung disease and neurodegeneration. Furthermore, genetic inactivation of TNFR1 and TNFR2 blunted transcription of cytokines, chemokines and adhesions proteins, which result from chronic STING activation in SAVI mice. In addition, increased transendothelial migration of neutrophils was ameliorated. Taken together, our results demonstrate a pivotal role of TNFR-signaling in the pathogenesis of SAVI in mice and suggest that available TNFR antagonists could ameliorate SAVI in patients.

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Fast recovery with etanercept in patients affected by polymyalgia rheumatica and decompensated diabetes: a case-series study

Cited by 11 publications

References 18 publications

Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial

Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial

Comorbidity in polymyalgia rheumatica

Tissue inflammation induced by constitutively active STING is mediated by enhanced TNF signaling

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