Abstract
Polymyalgia rheumatica (PMR) is a chronic inflammatory disorder that affects the elderly and is characterized by aching and morning stiffness in the shoulders, neck and pelvic girdles. The gold standard therapeutic drug is corticosteroid, but steroid-sparing or alternative treatment strategy needs to be developed due to the high frequency of relapse and steroid-induced adverse events such as osteoporosis, hypertension, and diabetic mellitus. The current evidence suggests that methotrexate and TNF inhibitors such as infliximab and etanercept may become optional drugs for PMR patients, who repeatedly relapsed and complicated with steroid-induced adverse events. Since IL-6 plays a central pathological role in PMR, IL-6 blockade is a promising therapeutic approach for PMR. Indeed, several case studies reported that tocilizumab was efficacious for refractory PMR patients as well as PMR-related diseases such as giant cell arteritis and remitting seronegative symmetrical synovitis with pitting edema. Further clinical evaluation is required for indication of tocilizumab for PMR and other related diseases.
