Polymyalgia rheumatica following COVID-19 vaccination: a case-series of ten patients

ObjectiveTo assess whether the polymyalgia rheumatica (PMR)-like syndrome reported as an immune related adverse event (irAE) from checkpoint inhibitor therapy is consistent with the 2012 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) provisional criteria for PMR.MethodsThe cases were derived from two sources. Group 1 represents reported cases from three contributing centres. Group 2 was derived from a systematic review of the literature searching for all cases reported as PMR or PMR-like illness associated with checkpoint inhibitor therapy. Cases were assessed for the quality of reporting and then analysed to determine whether they fulfilled the 2012 EULAR/ACR provisional criteria for PMR.ResultsA total of 49 patients were included for analysis. Among the entire group, 37 (75%) were designated ‘complete’ indicating that they had sufficient data to reliably apply the 2012 EULAR/ACR criteria. 28 (75%) cases fulfilled complete criteria for PMR. A number of cases also demonstrated some clinical features unusual for idiopathic PMR.ConclusionThis study suggests a high proportion of reported cases of checkpoint inhibitor-related PMR fulfil preliminary criteria for PMR, yet in one quarter clinical details were incomplete making verification problematic. Furthermore, in the absence of a gold standard for the diagnosis of PMR, the relationship of checkpoint inhibitor-related PMR to the idiopathic form remains unclear.

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SAT0517 Mizoribine Is as Effective Steroid-Sparing Agent as Methotrexate for Polymyalgia Rheumatica: A Retrospective Case Series Analysis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-eular.3365 ◽

2016 ◽

Vol 75 (Suppl 2) ◽

pp. 856.3-857 ◽

Cited By ~ 1

Author(s):

K. Shiraishi ◽

M. Suda ◽

R. Rokutanda ◽

M. Okada

Keyword(s):

Polymyalgia Rheumatica ◽

Case Series ◽

Retrospective Case ◽

Series Analysis ◽

Retrospective Case Series ◽

Steroid Sparing

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Leflunomide as a Corticosteroid-Sparing Agent in Giant Cell Arteritis and Polymyalgia Rheumatica: A Case Series

BioMed Research International ◽

10.1155/2013/120638 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 51

Author(s):

Andreas P. Diamantopoulos ◽

Helene Hetland ◽

Geirmund Myklebust

Keyword(s):

Randomized Controlled Trials ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Polymyalgia Rheumatica ◽

Case Series ◽

Controlled Trials ◽

Prednisolone Dose ◽

Randomized Controlled

Objectives. Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) affect individuals older than 50 years of age and corticosteroids are the mainstay of treatment. The aim of our study was to explore the role of leflunomide as a corticosteroid-sparing agent in GCA and PMR patients.Methods. Patients with difficult-to-treat GCA and PMR were retrospectively identified in the period from 2010 to 2013. The doses of corticosteroids and CRP values were noted before, after three months, and at the end of the treatment with leflunomide (for patients continuing treatment, censoring date was January 1, 2013).Results. Twenty-three patients were identified (12 with PMR and 11 with GCA). A reduction of 6 mg/dL (CI 95% –10.9–34.2,P=0.05) in CRP and 3.7 mg (CI 95% 0.5–7.0,P=0.03) in prednisolone dose was observed in the PMR group. In GCA patients, the reduction was 12.4 mg/dL (CI 95% 0.7–25.5,P=0.06) in CRP and 6.6 mg (CI 95% 2.8–10.3,P<0.01) in prednisolone dose.Conclusion. Leflunomide seems to be effective as a corticosteroid-sparing agent in patients with difficult-to-treat GCA and PMR. Randomized controlled trials are warranted in order to confirm the usefulness of leflunomide in the therapy of GCA/PMR.

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