Results of an open-label, phase II study presented at the annual meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals last week suggest that tocilizumab, currently approved to treat rheumatoid arthritis, may additionally benefit patients with polymyalgia rheumatica. The inflammatory disorder is predominantly found in individuals over the age of 65 and impacts 1% of people over the age of 50. At present, corticosteroids are the usual treatment option, but are accompanied by a range of adverse effects including skin fragility, diabetes, osteoporosis, cognitive disturbances, and muscle weakness. Polymyalgia rheumatica causes muscle pain and stiffness, especially in the shoulders, and can also trigger flu symptoms, with mild fever, fatigue, and malaise. This new treatment, due to costs and the healthcare system, may be reserved for select patients.
Tocilizumab is designed to block the cytokine interleukin-6, a protein involved in various inflammatory disorders. Prior research has shown that patients with polymyalgia rheumatica have elevated levels of interleukin-6. To test the effectiveness of tocilizumab, investigators at the Hospital for Special Surgery in New York studied 10 subjects with newly diagnosed polymyalgia rheumatica who had received less than 1 month of treatment with corticosteroids. Subjects received tocilizumab once a month by intravenous infusion in addition to corticosteroids, but were tapered off the steroids within 4 months. All subjects who completed the trial achieved relapse-free remission lasting 12 months or longer, compared to a 60% relapse rate for a control group who received corticosteroid therapy alone.
Read more about the findings here.