The sequential analysis of T lymphocyte subsets and interleukin-6 in polymyalgia rheumatica patients as predictors of disease remission and steroid withdrawal

Br J Rheumatol. 1997 Sep;36(9):976-80. doi: 10.1093/rheumatology/36.9.976.


CD4 and CD8 T lymphocyte subsets, the late T cell activation marker, HLA-DR, and serum interleukin-6 (IL-6) levels of 57 polymyalgia rheumatica (PMR) patients were followed over 2 yr to investigate whether they could be used to predict the safe withdrawal of steroid therapy. Cell phenotypes were studied by flow cytometry and IL-6 levels by ELISA. %CD8 cells were reduced below the normal range in PMR patients prior to steroid therapy. In 56% of patients, the %CD8 T lymphocytes failed to return to normal levels when quiescent disease allowed cessation of steroid therapy. Activated CD8 T cells, as detected by HLA-DR positivity, were above the normal range at the initiation of therapy and showed a negative correlation with %CD8 T cells. The serum concentration of IL-6 fluctuated over 24 months, and the correlation between IL-6 and erythrocyte sedimentation rate (ESR) seen prior to treatment was not seen at later intervals. The %CD8 T cell and serum IL-6 levels are not a good indicator of disease activity in PMR and are, therefore, unable to predict the safe withdrawal of steroids.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Anti-Inflammatory Agents / administration & dosage*
  • CD4-CD8 Ratio*
  • CD4-Positive T-Lymphocytes / chemistry
  • CD4-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / chemistry
  • CD8-Positive T-Lymphocytes / immunology
  • HLA-DR Antigens / analysis
  • Humans
  • Injections, Intramuscular
  • Interleukin-6 / blood*
  • Methylprednisolone / administration & dosage
  • Polymyalgia Rheumatica / drug therapy*
  • Polymyalgia Rheumatica / immunology
  • Prednisolone / administration & dosage*
  • Remission, Spontaneous
  • T-Lymphocyte Subsets / immunology


  • Anti-Inflammatory Agents
  • HLA-DR Antigens
  • Interleukin-6
  • Prednisolone
  • Methylprednisolone