Acute-phase reactants and the risk of relapse/recurrence in polymyalgia rheumatica : a prospective followup study
OBJECTIVE: To determine laboratory parameters that may be useful in identifying polymyalgia rheumatica (PMR) patients who require long-term corticosteroid therapy.
METHODS: A prospective followup study of 94 consecutive untreated patients with PMR were assessed for relapse/recurrence for a mean of 39 months. This cohort represented all the patients diagnosed over a 4-year period in 2 Italian secondary referral centers. Patients were monitored for clinical signs and symptoms, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum interleukin-6 (IL-6). IL-6 levels were also measured in 43 controls matched to the patients for age and sex.
RESULTS: The ESR was elevated in 91.5% of the patients prior to therapy initiation, as were CRP in 98.9% and serum IL-6 in 92.6%. Forty-seven (50.0%) patients had at least 1 relapse/recurrence during the followup period and 24 (25.5%) had at least 2. After 4 weeks of prednisone therapy, ESR was elevated in 13.2% patients, CRP in 41.9%, and serum IL-6 in 37.2%. IL-6 levels remained persistently elevated in 9.9% and CRP in 8.7% of patients during the first year of followup, whereas no patient had persistently elevated ESR. Persistently elevated CRP and IL-6 levels were significantly associated with an increased risk of relapse/recurrence. In particular, patients with persistently elevated levels of IL-6 during the first year of therapy had the highest relative risk.
CONCLUSION: Despite the control of clinical symptoms, corticosteroids do not adequately control the inflammatory process in a subset of patients with PMR who have persistently elevated levels of CRP and IL-6 and who have a higher risk of relapsing.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2005 |
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| Erschienen: |
2005 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:53 |
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| Enthalten in: |
Arthritis and rheumatism - 53(2005), 1 vom: 15. Feb., Seite 33-8 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Salvarani, Carlo [VerfasserIn] |
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| Themen: |
9007-41-4 |
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| Anmerkungen: |
Date Completed 29.03.2005 Date Revised 09.04.2022 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM153543841 |
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| LEADER | 01000naa a22002652 4500 | ||
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| 041 | |a eng | ||
| 100 | 1 | |a Salvarani, Carlo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Acute-phase reactants and the risk of relapse/recurrence in polymyalgia rheumatica |b a prospective followup study |
| 264 | 1 | |c 2005 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
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| 500 | |a Date Completed 29.03.2005 | ||
| 500 | |a Date Revised 09.04.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To determine laboratory parameters that may be useful in identifying polymyalgia rheumatica (PMR) patients who require long-term corticosteroid therapy | ||
| 520 | |a METHODS: A prospective followup study of 94 consecutive untreated patients with PMR were assessed for relapse/recurrence for a mean of 39 months. This cohort represented all the patients diagnosed over a 4-year period in 2 Italian secondary referral centers. Patients were monitored for clinical signs and symptoms, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum interleukin-6 (IL-6). IL-6 levels were also measured in 43 controls matched to the patients for age and sex | ||
| 520 | |a RESULTS: The ESR was elevated in 91.5% of the patients prior to therapy initiation, as were CRP in 98.9% and serum IL-6 in 92.6%. Forty-seven (50.0%) patients had at least 1 relapse/recurrence during the followup period and 24 (25.5%) had at least 2. After 4 weeks of prednisone therapy, ESR was elevated in 13.2% patients, CRP in 41.9%, and serum IL-6 in 37.2%. IL-6 levels remained persistently elevated in 9.9% and CRP in 8.7% of patients during the first year of followup, whereas no patient had persistently elevated ESR. Persistently elevated CRP and IL-6 levels were significantly associated with an increased risk of relapse/recurrence. In particular, patients with persistently elevated levels of IL-6 during the first year of therapy had the highest relative risk | ||
| 520 | |a CONCLUSION: Despite the control of clinical symptoms, corticosteroids do not adequately control the inflammatory process in a subset of patients with PMR who have persistently elevated levels of CRP and IL-6 and who have a higher risk of relapsing | ||
| 650 | 4 | |a Clinical Trial | |
| 650 | 4 | |a Controlled Clinical Trial | |
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Acute-Phase Proteins |2 NLM | |
| 650 | 7 | |a Antirheumatic Agents |2 NLM | |
| 650 | 7 | |a Glucocorticoids |2 NLM | |
| 650 | 7 | |a Interleukin-6 |2 NLM | |
| 650 | 7 | |a C-Reactive Protein |2 NLM | |
| 650 | 7 | |a 9007-41-4 |2 NLM | |
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| 700 | 1 | |a Cantini, Fabrizio |e verfasserin |4 aut | |
| 700 | 1 | |a Niccoli, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Macchioni, Pierluigi |e verfasserin |4 aut | |
| 700 | 1 | |a Consonni, Dario |e verfasserin |4 aut | |
| 700 | 1 | |a Bajocchi, Gianluigi |e verfasserin |4 aut | |
| 700 | 1 | |a Vinceti, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Catanoso, Maria Grazia |e verfasserin |4 aut | |
| 700 | 1 | |a Pulsatelli, Lia |e verfasserin |4 aut | |
| 700 | 1 | |a Meliconi, Riccardo |e verfasserin |4 aut | |
| 700 | 1 | |a Boiardi, Luigi |e verfasserin |4 aut | |
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