Efficacy of first-line tocilizumab therapy in early polymyalgia rheumatica: a prospective longitudinal study.

Abstract : Glucocorticoids are the cornerstone treatment of polymyalgia rheumatica (PMR) but induce adverse events. To evaluate the efficacy and safety of first-line tocilizumab in PMR. In a prospective open-label study (ClinicalTrials.gov: NCT01713842), 20 glucocorticoid-free patients fulfilling Chuang's PMR criteria, with symptom onset within the last 12 months and a PMR activity score (PMR-AS) >10, each received three tocilizumab infusions at 4-week intervals, without glucocorticoids, followed by oral prednisone from weeks 12 to 24 (0.15 mg/kg if PMR-AS ≤10 and 0.30 mg/kg otherwise). The primary end point was the proportion of patients with PMR-AS≤10 at week 12. Baseline median PMR-AS was 36.6 (IQR 30.4-43.8). At week 12, all patients had PMR-AS≤10 and received the low prednisone dosage. Median PMR-AS at weeks 12 and 24 was 4.5 (3.2-6.8) and 0.95 (IQR 0.4-2), respectively (p<0.001 vs baseline for both time points). No patient required rescue treatment. Positron emission tomography-CT showed significant improvements. The most common adverse events were transient neutropenia (n=3) and leucopenia (n=5); in one patient, the second tocilizumab infusion was omitted due to leucopenia. Tocilizumab monotherapy is effective in recent-onset PMR. Randomised controlled trials are warranted. NCT01713842.
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http://hal.univ-brest.fr/hal-01282810
Contributeur : Ghislaine Calvez <>
Soumis le : vendredi 4 mars 2016 - 13:14:19
Dernière modification le : lundi 18 décembre 2017 - 14:40:13

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Valérie Devauchelle-Pensec, Jean Marie Berthelot, Divi Cornec, Yves Renaudineau, Thierry Marhadour, et al.. Efficacy of first-line tocilizumab therapy in early polymyalgia rheumatica: a prospective longitudinal study.. Annals of the Rheumatic Diseases, BMJ Publishing Group, 2016, 〈10.1136/annrheumdis-2015-208742〉. 〈hal-01282810〉

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