Abstract
We enrolled nine consecutive patients affected by newly diagnosed polymyalgia rheumatica and decompensated diabetes mellitus. All patients were treated with etanercept (25 mg twice weekly) and prednisone and were followed up to 1 year. At the sixth-month follow-up, etanercept and prednisone were withdrawn. Patients were seen at regular intervals (days 0, 30, 60, 90, 150, 180) and the following variables determined: erythrocytes sedimentation rate, C-reactive protein, fasting serum glucose, pain measured by visual analog scale, and the Health Assessment Questionnaire. Our results indicate that etanercept might have some steroid-sparing effects, but controlled investigations are needed to support etanercept use in clinical practice for this kind of patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Cimmino MA, Zaccaria A (2000) Epidemiology of polymyalgia rheumatica. Clin Exp Rheumatol 18(suppl 20):S9–S11
Salvarani C, Macchioni P, Bioardi L (1997) Polymyalgia rheumatica. Lancet 350:43–47
Kyle V (1997) Polymyalgia reumatica. Prescribers’ J 3:138–144
Chuang T, Hunder GG, Ilstrup DM, Kurland LT (1982) Polymyalgia rheumatica—a 10 year epidemiological and clinical study. Ann Intern Med 97:672–680
Cimmino MA, Moggiana G, Montecucco C, Caporali R, Accardo S (1994) Long term treatment of polymyalgia rheumatica with deflazacort. Ann Rheum Dis 53:331–333
Gran JT (1999) Current therapy of polymyalgia rheumatica [editorial]. Scand J Rheumatol 28:269–272
Salvarani C, Cantini F, Boiardi L, Hunder GG (2002) Polymyalgia rheumatica and giant-cell arteritis. N Engl J Med 347:261–271
Salvarani C, Boiardi L, Mantovani V, Ranzi A, Cantini F, Olivieri I et al (1999) HLA-DRB1 alleles associated with polymyalgia rheumatica in northern Italy: correlation with disease severity. Ann Rheum Dis 58:303–308
Jover JA, Hernandez-Garcia C, Morado IC, Vargas E, Banares A, Fernandez-Gutierrez B (2001) Combined treatment of giant-cell arteritis with methotrexate and prednisone. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 134:106–114
Hoffman GS, Cid MC, Hellmann DB, Guillevin L, Stone JH, Schousboe J et al (2002) A multicenter, randomized, double-blind, placebo-controlled trial of adjuvant methotrexate treatment for giant cell arteritis. Arthritis Rheum 46:1309–1318
Caporali R, Cimmino MA, Ferraccioli G, Gerli R, Klersy C, Salvarani C et al (2004) Prednisone plus methotrexate for polymyalgia rheumatica. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 141:493–500
Salvarani C, Macchioni P, Manzini C, Paolazzi G, Trotta A, Manganelli P et al (2007) Infliximab plus prednisone or placebo plus prednisone for the initial treatment of polymyalgia rheumatica: a randomized trial. Ann Intern Med 46(9):631–639
The Oxford Centre for Evidence-based Medicine Levels of Evidence (2007) http://www.pdptoolkit.co.uk/Files/ebm/indexes/guide%20to%20ebm.htm Accessed July 2 2007
Kalke S, Mukerjee D, Dasgupta B (2000) A study of the health assessment questionnaire to evaluate functional status in polymyalgia rheumatica. Rheumatology 39(8):883–885
Salvarani C, Cantini F, Niccoli L, Catanoso MG, Macchioni P, Pulsatelli L et al (2003) Treatment of refractory polymyalgia rheumatica with infliximab: a pilot study. J Rheumatol 30(4):760–763
Migliore A, Massafra U, Carloni E, Padalino C, Martin Martin S, Lasaracina F et al (2005) TNF-alpha blockade induce clinical remission in patients affected by polymyalgia rheumatica associated to diabetes mellitus and/or osteoporosis: a seven cases report. Eur Rev Med Pharmacol Sci 9(6):373–378
Tam LS, Tomlinson B, Chu TT, Li TK Li EK (2007) Impact of TNF inhibition on insulin resistance and lipids levels in patients with rheumatoid arthritis. Clin Rheumatol 26(9):1495–1498
Gonzalez-Gay MA, De Matias JM, Gonzalez-Juanatey C, Garcia-Porrua C, Sanchez-Andrade A, Martin J, Llorca J (2006) Anti-tumor necrosis factor-alpha blockade improves insulin resistance in patients with rheumatoid arthritis. Clin Exp Rheumatol 24(1):83–86
Yazdani-Biuki B, Mueller T, Brezinschek HP, Hermann J, Graninger W, Wascher TC (2006) Relapse of diabetes after interruption of chronic administration of anti-tumor necrosis factor-alpha antibody infliximab: a case observation. Diabetes Care 29(7):1712–1713
Adachi T, Toishi T, Takashima E, Hara H (2006) Infliximab neutralizes the suppressive effect of TNF-alpha on expression of extracellular-superoxide dismutase in vitro. Biol Pharm Bull 29(10):2095–2098
Iyama S, Okamoto T, Sato T, Yamauchi N, Sato Y, Sasaki K et al (2001) Treatment of murine collagen-induced arthritis by ex vivo extracellular superoxide dismutase gene transfer. Arthritis Rheum 44(9):2160–2167
Adachi T, Inoue M, Hara H, Maehata E, Suzuki S (2004) Relationship of plasma extracellular-superoxide dismutase level with insulin resistance in type 2 diabetic patients. J Endocrinol 181(3):413–417
Bernstein LE, Berry J, Kim S, Canavan B, Grinspoon SK (2006) Effects of etanercept in patients with the metabolic syndrome. Arch Intern Med 166(8):902–908
Acknowledgments
We thank Paola Martorana a lot for language revision of this manuscript.
Disclosures
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Corrao, S., Pistone, G., Scaglione, R. et al. Fast recovery with etanercept in patients affected by polymyalgia rheumatica and decompensated diabetes: a case-series study. Clin Rheumatol 28, 89–92 (2009). https://doi.org/10.1007/s10067-008-1026-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-008-1026-6