Rheumatology, CHU (University Teaching Hospital), Besançon, France.
EA4266 EPILAB, Université de Franche-Comté, Besançon, France.
Expert Opin Biol Ther. 2023 Jul-Dec;23(12):1255-1263. doi: 10.1080/14712598.2023.2287097. Epub 2023 Dec 28.
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disease of the elderly, treated mainly with systemic corticosteroids. The frequency of side effects of steroids is high in this aged population and increased due to comorbidities. The use of biological treatments could be of interest in this condition.
This review takes into account literature data from the PubMed and clinical trial databases concerning the results of the use of biological treatments in PMR, in terms of efficacy and safety of these treatments.
Current data do not allow us to identify any particular efficacy of the various anti-TNF agents used in the treatment of PMR. Anti-interleukin 6 agents (tocilizumab, sarilumab) have shown consistent efficacy results, suggesting a particularly interesting steroid-sparing effect in the population under consideration. The safety profile appears acceptable. Other biologic targeted treatments are currently being evaluated. Anti-interleukin-6 agents may well have a place in the therapeutic strategy for PMR, particularly for patients with steroid-resistant disease or at high risk of complications of corticosteroid therapy.
巨细胞动脉炎（PMR）是一种老年人的炎症性风湿性疾病，主要采用全身皮质类固醇治疗。在这个老年人群体中，类固醇的副作用发生率很高，并且由于合并症而增加。生物治疗的应用对此病症可能具有一定的意义。
本综述考虑了来自 PubMed 和临床试验数据库的文献数据，这些数据涉及生物治疗在 PMR 中的应用的疗效和安全性。
目前的数据尚不能确定在 PMR 治疗中使用的各种抗 TNF 药物的任何特定疗效。抗白细胞介素 6 制剂（托珠单抗、沙利鲁单抗）显示出一致的疗效结果，这表明在考虑的人群中具有特别有趣的类固醇节约效应。安全性特征似乎可以接受。其他生物靶向治疗正在评估中。抗白细胞介素 6 制剂可能在 PMR 的治疗策略中占有一席之地，特别是对于类固醇耐药疾病或皮质类固醇治疗并发症风险高的患者。
