Treatment of palindromic rheumatism: A systematic review

Kavandi, Hadiseh; Hashemi, Seyedeh Zohreh; Khalesi, Elena; Khabbazi, Alireza

doi:10.1111/ijcp.14868

Cited by 4 publications

(6 citation statements)

References 35 publications

(89 reference statements)

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“…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 . Case series with limited number of cases and variable duration of follow up reported the efficacy of antimalarials, colchicine, gold and rituximab in the control of symptoms of PR 5 .…”

Section: Introductionmentioning

confidence: 99%

“…Case series with limited number of cases and variable duration of follow up reported the efficacy of antimalarials, colchicine, gold and rituximab in the control of symptoms of PR 5 . Based on the available evidence, it is recommended to start PR treatment with hydroxychloroquine (HCQ) 5 . However, HCQ could not control attacks of PR in 20%‐85% of cases 6 .…”

Section: Introductionmentioning

confidence: 99%

“…5 Based on the available evidence, it is recommended to start PR treatment with hydroxychloroquine (HCQ). 5 However, HCQ could not control attacks of PR in 20%-85% of cases. 6 Recently, Padhan et al reported the efficacy of methotrexate (MTX) in the treatment of 15 patients with seropositive PR with inadequate response to HCQ.…”

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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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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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“…Nevertheless, researchers have attempted to treat PR with anti‐RA drugs, such as NSAIDs, DMADs, glucocorticoids, and antimalarials, with some promising effects. Notably, the antimalarial drug hydroxychloroquine sulfate (HCQ) has gradually become a treatment option for long‐term management in patients with PR 13 . A prospective study showed that 47.78% of patients with PR treated with HCQ achieved complete disease control 14 .…”

Section: Discussionmentioning

confidence: 99%

Iguratimod efficacy in palindromic rheumatism treatment

Yuan

Luo

et al. 2023

Immunity Inflam & Disease

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Background As a new immunomodulator for rheumatoid arthritis, iguratimod (IGU) also has therapeutic potential in other immune diseases. In this study, we determined the effects of IGU on disease control in patients with palindromic rheumatism (PR). Methods Patients with PR were divided into Control group (Ctrl group) and an IGU treatment (IGU group) groups. Drug efficacy was evaluated according to the frequency of PR attacks (monthly), the visual analog scale (VAS) score of patient pain, and clinical symptoms. Results The drug positivity and disease control rates of the IGU group (100.00% and 90.91%, respectively) were significantly higher than those of the Ctrl group (61.11% and 5.56%; p = .002 and p < .001, respectively). The median number of PR flares and the VAS score of patients in the Ctrl group decreased from 3.00 (1.00–15.00) to 0.83 (0.00–12.00) and from 5 (4–6) to 4 (1–6), respectively. In the IGU group, the median number of PR attacks decreased from 4.50 (2.00–15.00) to 0.00 (0.00–0.33), and the VAS score decreased from 5 (4–6) to 0 (0–2). The IGU group exhibited a significant reduction in PR flare frequency and improvement in the VAS value (p < .001 and p < .001, respectively). Conclusion Our study is the first to describe the efficacy of IGU in PR treatment. IGU can significantly reduce the number of PR flares and improve the clinical symptoms of patients with PR.

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“…Treatment options for PR are limited and there is no guideline for treatment. Antimalarial drugs, mainly hydroxychloroquine (HCQ), are the most commonly used medications 4 . However, antimalarials do not control attacks in all patients and others have used medications like methotrexate (MTX) 5,6 and rituximab 7 …”

Section: Introductionmentioning

confidence: 99%

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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Treatment of palindromic rheumatism: A systematic review

Cited by 4 publications

References 35 publications

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

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

Iguratimod efficacy in palindromic rheumatism treatment

Efficacy of leflunomide in the treatment of palindromic rheumatism

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