Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455-3o andar-Reumatologia, sala 3190, São Paulo 01246-903, Brazil.
Clin Rheumatol. 2012 Mar;31(3):575-9. doi: 10.1007/s10067-011-1914-z. Epub 2012 Jan 11.
The objective of this study was to analyze the clinical, laboratorial, and therapeutical response of polymyalgia rheumatica (PMR) to anti-tumor necrosis factor (anti-TNF) treatment. We systematically searched English articles on the subjects of PMR who were treated with TNF blockers in Pubmed from 1994 to 2010. In addition, we reported on two patients with PMR who were treated by the Rheumatology Division of the Hospital das Clínicas da Faculdade de Medicina da Universidade in São Paulo, Brazil. Ninety-nine cases of patients with PMR treated with anti-TNF were reviewed. The age of these patients ranged from 63 to 84 years, and 70.7% of them were female. Disease duration varied from 10.5 weeks to 95 months, and time of follow-up varied from 2 weeks to 21 months. Infliximab was the anti-TNF of choice in three studies, while etanercept was in five. Time to response varied from 2 to 8 weeks. After anti-TNF treatment, prednisone reduction was observed in all studies. Clinical improvement was found in 7/7 studies, and laboratory improvement of at least 50% of inflammatory markers was observed in 6/7 studies. This study demonstrated a good clinical and laboratory response to anti-TNF therapy in patients with PMR, with or without glucocorticoid.
本研究旨在分析肿瘤坏死因子（TNF）拮抗剂治疗巨细胞动脉炎（PMR）的临床、实验室和治疗反应。我们系统地检索了 1994 年至 2010 年期间在 Pubmed 上发表的关于 PMR 患者接受 TNF 阻滞剂治疗的英文文章。此外，我们还报告了巴西圣保罗大学医学院附属医院风湿病科治疗的 2 例 PMR 患者。共回顾了 99 例接受抗 TNF 治疗的 PMR 患者。这些患者的年龄为 63 至 84 岁，其中 70.7%为女性。疾病持续时间从 10.5 周到 95 个月不等，随访时间从 2 周到 21 个月不等。三项研究中选择英夫利昔单抗，五项研究中选择依那西普。反应时间从 2 周到 8 周不等。接受抗 TNF 治疗后，所有研究均观察到泼尼松减量。7/7 项研究发现临床改善，6/7 项研究发现炎症标志物至少改善 50%。这项研究表明，PMR 患者在使用或不使用糖皮质激素的情况下，对 TNF 治疗有良好的临床和实验室反应。
