Treatment of refractory polymyalgia rheumatica with etanercept: an open pilot study

Arthritis Rheum. 2007 Dec 15;57(8):1514-9. doi: 10.1002/art.23095.


Objective: To investigate whether etanercept has a steroid-sparing effect in the treatment of patients with relapsing polymyalgia rheumatica (PMR).

Methods: The study group comprised patients with relapsing PMR who were not able to reduce their prednisone dosage below 7.5-10 mg/day and who had experienced corticosteroid-related side effects. Patients received injections of etanercept 25 mg twice weekly for 24 weeks, and were followed up for 3 additional months after treatment withdrawal. Patients regularly underwent clinical assessment, measurement of erythrocyte sedimentation rate and C-reactive protein level, and ultrasound (US) examination of the shoulders during the 9 months of the followup period.

Results: All 6 enrolled patients responded to etanercept with sustained remission (improvement of at least 70% according to European League Against Rheumatism response criteria for PMR in 4 patients and at least 50% in 2 patients) and were able to significantly reduce their median prednisone daily dosage without experiencing a disease relapse (8.75 mg versus 2.5 mg; P = 0.026) at the end of the 9-month study period. US shoulder examination performed at the end of followup demonstrated a parallel reduction of glenohumeral and periarticular inflammation. A significant reduction in the cumulative prednisone dose 9 months before versus the 9-month study period was observed (mean +/- SD 1,767 +/- 524 mg versus 730 +/- 182 mg; P = 0.028). Three patients developed nonsevere side effects: bacterial cystitis in 2 and influenza in 1.

Conclusion: These results, which should be confirmed in a controlled study, suggest that etanercept may be a safe and useful corticosteroid-sparing agent in relapsing PMR.

Publication types

  • Clinical Trial

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Aged, 80 and over
  • Antirheumatic Agents / adverse effects
  • Antirheumatic Agents / therapeutic use*
  • Blood Sedimentation
  • C-Reactive Protein / metabolism
  • Dose-Response Relationship, Drug
  • Etanercept
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin G / adverse effects
  • Immunoglobulin G / therapeutic use*
  • Male
  • Middle Aged
  • Pilot Projects
  • Polymyalgia Rheumatica / blood
  • Polymyalgia Rheumatica / drug therapy*
  • Prednisone / adverse effects
  • Prednisone / therapeutic use
  • Receptors, Tumor Necrosis Factor / therapeutic use*
  • Treatment Outcome


  • Adrenal Cortex Hormones
  • Antirheumatic Agents
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • C-Reactive Protein
  • Etanercept
  • Prednisone