Steroid-sparing agents in polymyalgia rheumatica: how will they fit into the treatment paradigm?

Abstract

INTRODUCTION:

Polymyalgia rheumatica is a common inflammatory rheumatic disease in subjects aged 50 years or older and classically presents with shoulder and/or pelvic girdle pain and prolonged morning stiffness. Glucocorticoids represent the standard of treatment; glucocorticoid therapy is usually required for 1-2 years and often results in significant glucocorticoid-related side effects, especially in the elderly.

AREAS COVERED:

In this review, we aimed to provide a comprehensive overview of the management of polymyalgia rheumatica, with a particular focus on adjunctive therapies to the standard glucocorticoid treatment.

EXPERT OPINION:

Given the high frequency of disease relapses (one-third of patients) and the adverse events related to prolonged glucocorticoid use, the need for glucocorticoid-sparing agents remains an important issue in the management of polymyalgia rheumatica. In selected patients, who are at risk for glucocorticoid-related side effects or in those with glucocorticoid-refractory disease, the addition of a glucocorticoid-sparing agent, either a synthetic or biologic disease-modifying anti-rheumatic drug, may represent a reasonable and effective therapeutic approach.

• Authors: Caterina Ricordi, Nicolò Pipitone, Chiara Marvisi, Francesco Muratore, Carlo Salvarani
• Journal: Expert review of clinical immunology (Expert Rev Clin Immunol) 2023 Jul-Dec Vol. 19 Issue 10 Pg. 1195-1203 ISSN: 1744-8409 [Electronic] England
• PMID: 37480289 (Publication Type: Journal Article, Review)

Chemical References

• Glucocorticoids
• Antirheumatic Agents
• Steroids

Topics

• Aged
• Humans
• Polymyalgia Rheumatica (drug therapy)
• Glucocorticoids (therapeutic use)
• Giant Cell Arteritis (drug therapy)
• Antirheumatic Agents (therapeutic use)
• Steroids (therapeutic use)