Palindromic rheumatism: a unique and enigmatic entity with a complex relationship with rheumatoid arthritis

Sanmartí, Raimón; Haro, Isabel; Cañete, Juan D.

doi:10.1080/1744666x.2021.1899811

Cited by 11 publications

(27 citation statements)

References 61 publications

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“…PR has immunogenetic, clinical and serological associations with rheumatoid arthritis (RA) and may progress into chronic diseases, mainly RA 2,3 . It has been reported that PR progresses to RA in 10%‐66% of cases, mainly within 10 years of the onset of the disease 2‐4 . Although various studies show that treatment with disease‐modifying antirheumatic drugs (DMARDs) can control attacks of PR and prevent or postpone progression of disease to RA, no controlled studies have been performed about the efficacy of various DMARDs on the treatment of PR and there is no guideline for the treatment of PR 5 .…”

Section: Introductionmentioning

confidence: 99%

“…1 PR has immunogenetic, clinical and serological associations with rheumatoid arthritis (RA) and may progress into chronic diseases, mainly RA. 2,3 It has been reported that PR progresses to RA in 10%-66% of cases, mainly within 10 years of the onset of the disease. [2][3][4]…”

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confidence: 99%

“…2,3 It has been reported that PR progresses to RA in 10%-66% of cases, mainly within 10 years of the onset of the disease. [2][3][4]…”

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confidence: 99%

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Long‐term outcome of patients with palindromic rheumatism treated with methotrexate

et al. 2022

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Objective Palindromic rheumatism (PR) is characterized by self‐resolving and short duration attacks of arthritis/periarthritis. The present study was performed to report the results of PR treatment with methotrexate (MTX). Methods We reviewed the charts of 152 patients with diagnosis of PR. Inclusion criteria were diagnosis of PR according to the criteria of Weismann, age ≥16, active disease and treatment with MTX for at least 6 months. Disease outcome was assessed by reaching remission and prevention of disease evolution to chronic arthritis. Remission was defined as stopping the attacks for 12 weeks and prednisolone dose ≤5 mg/d. MTX treatment failure was defined as failure to achieve remission, the need to add other disease‐modifying antirheumatic drugs and disease progression to chronic arthritis. Results Fifty‐nine patients were included in the study. Median duration of follow‐up was 43 months. Attacks were controlled in 89.8% of patients. In 80% of the patients remission occurred during 12 months after starting treatment with MTX. Treatment failed in 20.3% of patients. Wrist joint involvement and positive rheumatoid factor (RF) were significantly more common in the MTX treatment‐failed group. In RF positive patients evolution to rheumatoid arthritis was more common than in RF negative patients. No significant differences were observed in remission rate and evolution to rheumatoid arthritis in anticitrullinated C peptide positive and negative patients. Conclusions The present study, demonstrated the efficacy of MTX in controlling PR in seropositive and seronegative patients over a median of 43 months of treatment.

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Long‐term outcome of patients with palindromic rheumatism treated with methotrexate

et al. 2022

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“…20 The presence of autoantibodies in most patients with PR and the evolution of the disease to RA in a significant number of patients introduced a prominent role of autoimmunity in the pathogenesis of PR. [1][2][3] However, the relapsing remitting course of the disease and the higher frequency of MEFV gene mutation have raised the role of inflammasome-related mechanisms in the pathogenesis of PR, giving it the appearance of an autoinflammatory disease. 1,20,21 The main mechanism of action of leflunomide in RA and other autoimmune diseases is inhibition of lymphocytes proliferation.…”

Section: Discussionmentioning

confidence: 99%

“…1 The role of systemic autoimmunity in the pathogenesis of PR has been suggested due to the presence of autoantibodies including rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs) in most patients and the disease evolution to rheumatoid arthritis (RA) in 10%-65% of patients. [1][2][3] The goal of treatment in PR is to control the attacks and prevent disease evolution to chronic arthritis. 1 Treatment options for PR are limited and there is no guideline for treatment.…”

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Efficacy of leflunomide in the treatment of palindromic rheumatism

2022

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Objective The goal of treatment in palindromic rheumatism (PR) is to control the attacks and prevent disease evolution to chronic arthritis. Conventional synthetic disease‐modifying antirheumatic drugs (csDMARDs) including antimalarial and methotrexate cannot control attacks in all patients. Methods In this retrospective study, we assessed the efficacy of leflunomide in patients with PR who had an inadequate response to DMARDs. In this study, patients who had a diagnosis of PR and were treated with leflunomide because of active disease despite treatment with csDMARDs for at least 6 months were included. Remission was defined as no attacks for 3 months and prednisolone dose ≤5 mg/d. Leflunomide treatment failure was defined as failure to achieve remission, the need to add other DMARDs for controlling attacks and disease progression to chronic arthritis during treatment with leflunomide. Results Ten cases with active disease despite treatment with hydroxychloroquine and methotrexate and low‐dose prednisolone treated with leflunomide were included in the study. During the 12.6 ± 7.5 months of treatment with leflunomide, the frequency of attacks significantly decreased. Complete and partial remission were achieved in 90% of patients. Conclusion Our results indicate that leflunomide controls PR attacks and it might be a new option for patients with PR.

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Seronegative palindromic rheumatism: what are we talking about? Comment on the article by Yang et al

Sanmarti

Frade‐Sosa

Morlà

et al. 2022

Arthritis & Rheumatology

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Palindromic rheumatism: a unique and enigmatic entity with a complex relationship with rheumatoid arthritis

Cited by 11 publications

References 61 publications

Long‐term outcome of patients with palindromic rheumatism treated with methotrexate

Long‐term outcome of patients with palindromic rheumatism treated with methotrexate

Efficacy of leflunomide in the treatment of palindromic rheumatism

Seronegative palindromic rheumatism: what are we talking about? Comment on the article by Yang et al

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