0
Sign In  | Subscribe
1 May 2007, Vol 146, No. 9>
Summaries for Patients | 1 May 2007

Adding Infliximab to the Treatment Regimen for Polymyalgia Rheumatica FREE

[+] Article and Author Information

The summary below is from the full report titled “Infliximab plus Prednisone or Placebo plus Prednisone for the Initial Treatment of Polymyalgia Rheumatica. A Randomized Trial.” It is in the 1 May 2007 issue of Annals of Internal Medicine (volume 146, pages 631-639). The authors are C. Salvarani, P.L. Macchioni, C. Manzini, G. Paolazzi, A. Trotta, P. Manganelli, M. Cimmino, R. Gerli, M.G. Catanoso, L. Boiardi, F. Cantini, C. Klersy, and G.G. Hunder.


Ann Intern Med. 2007;146(9):I-20. doi:10.7326/0003-4819-146-9-200705010-00002
Text Size: A A A

What is the problem and what is known about it so far?

Polymyalgia rheumatica (PMR) is a disease in which inflammation occurs throughout the body. Symptoms include weight loss; fever; muscle pain; aching of the neck, shoulder, and hip; and morning stiffness. The cause of PMR is unknown. It occurs most often in persons older than 50 years of age and increasingly often with advancing age. Polymyalgia rheumatica responds well to treatment with steroids, such as prednisone. However, patients usually need to stay on steroids for 1 to 2 years, and symptoms sometimes return (relapse) when steroid treatment is stopped. Patients can develop side effects from steroids, so we need better ways to treat PMR to decrease relapse and the amount of steroids needed to treat the disease. Infliximab is a drug that interacts with the immune system. A report suggested that infliximab decreased the amount of steroids needed in 4 patients with PMR who developed side effects from steroid treatment.

Why did the researchers do this particular study?

To find out whether treatment with infliximab improved outcomes for people with PMR.

Who was studied?

The researchers studied 51 patients with newly diagnosed PMR that were being treated with the steroid prednisone.

How was the study done?

The researchers assigned patients at random to receive an intravenous dose of either infliximab or a placebo (a substance that looked like infliximab but contained no active ingredient) at the start of the study and then after 2, 6, 14, and 22 weeks. All patients followed a schedule to slowly decrease the steroid dose from 15 mg to 0 mg over 16 weeks. If symptoms returned, they would need to increase the steroid dose and start to decrease the amount they received all over again. The researchers collected information on whether patients' symptoms returned (relapse) and on steroid dose over the course of the study.

What did the researchers find?

Infliximab did not seem to offer a large benefit in terms of preventing relapse of symptoms or in reducing the amount of steroids required for treatment of PMR.

What were the limitations of the study?

The study was small and lasted only 22 weeks, so the researchers could not rule out a small benefit of infliximab or a benefit if used for a longer period. Also, the study was too small to provide good information on the side effects of infliximab.

What are the implications of the study?

Infliximab is unlikely to result in large benefits when added to prednisone for patients with newly diagnosed PMR.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general jounals
BMJ 2010;341:c5893-c1494.

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Advertisement

Related Content

Customize your page view by dragging & repositioning the boxes below.

Journal Club
Topic Collections
PubMed Articles
Anti-TNF therapy for polymyalgia rheumatica: report of 99 cases and review of the literature.
Clinical rheumatology Issue date: 2012 Mar
Treatment of polymyalgia rheumatica: a systematic review.
Archives of internal medicine Issue date: 2009 Nov 9

Annals of Internal Medicine

Other Resources

Copyright © 2013 The American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Buy This Article

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Register Now for a free account
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)