| Long-term follow-up of polymyalgia rheumatica patients treated with methotrexate and steroids. | |
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MedLine Citation:
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PMID: 18578959 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: A series of patients with polymyalgia rheumatica (PMR) who received the steroid-sparing combination therapy, prednisone and methotrexate (MTX), underwent a long-term follow-up study at five years to investigate possible reductions of steroid-related side effects. Additional end-points were the number of patients still in need of steroid treatment, the cumulative steroid dose, and the number of flare-ups of PMR. PATIENTS AND METHODS: Fifty-seven PMR patients who were enrolled in a double-blind placebo-controlled randomised trial on the efficacy of MTX added to standard steroid treatment were reviewed after 5 years. Information was collected on the patients' previous health conditions or causes of death through a standardized questionnaire by direct visit, chart review, or interviews with relatives. RESULTS: After 6 years from initiation of therapy, MTX-treated patients had lower ESR (17.1+/-9.7 mm/h vs. 26.8+/-22.9 mm/h, p=0.08) and CRP (2.7+/-2.3 mg/L vs. 10.2+/-16.4 mg/L, p=0.04). 31% MTX-treated patients were still on steroids in comparison with 39.3% controls. The mean cumulative dosage of prednisone in MTX-treated patients was 2.6+/-3.8 g in comparison with 3.2+/-4.1 g for controls (p=0.6). PMR flare-ups were seen in 30.8% of MTX-treated patients and in 44.4% of controls (p=0.39). During the follow-up, 58 and 55 side effects were observed in MTX-treated patients and in controls, respectively. CONCLUSIONS: MTX-treated patients showed slightly less residual inflammation than controls, with the same incidence of steroid-related side effects. PMR is not a benign condition, as often reported, since one third of patients need steroid treatment for more than 6 years. |
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Authors:
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M A Cimmino; C Salvarani; P Macchioni; R Gerli; E Bartoloni Bocci; C Montecucco; R Caporali; |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical and experimental rheumatology Volume: 26 ISSN: 0392-856X ISO Abbreviation: Clin. Exp. Rheumatol. Publication Date: 2008 May-Jun |
Date Detail:
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Created Date: 2008-06-26 Completed Date: 2008-12-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8308521 Medline TA: Clin Exp Rheumatol Country: Italy |
Other Details:
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Languages: eng Pagination: 395-400 Citation Subset: IM |
Affiliation:
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Clinica Reumatologica, Dipartimento di Medicina Interna, Università di Genova, Italy. cimmino@unige.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Antirheumatic Agents / adverse effects, therapeutic use* Arthralgia / drug therapy Dose-Response Relationship, Drug Drug Therapy, Combination Female Follow-Up Studies Glucocorticoids / adverse effects, therapeutic use* Humans Longitudinal Studies Male Methotrexate / adverse effects, therapeutic use* Polymyalgia Rheumatica / drug therapy* Prednisone / adverse effects, therapeutic use* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antirheumatic Agents; 0/Glucocorticoids; 53-03-2/Prednisone; 59-05-2/Methotrexate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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