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Revmatická polymyalgie (PMR) a případně i obrovsko-buněčná temporální arteritida (TA) postihují relativně často osoby ve vyšším věku a mají akutní průběh s výrazným funkčním postižením. Projevy PMR mohou často připomínat revmatoidní artritidu (RA) a odlišit tyto jednotky nemusí být jednoduché. Z hlediska léčby má RA kromě chemických, chorobu modifikujících léků a glukokortikoidů k dispozici i biologickou léčbu, zatímco u PMR je dosud jedinou úspěšnou terapií léčba glukokortikoidy, která s sebou nese i množství nežádoucích účinků. Použití imunosupresivní léčby se jeví jako účelné u nemocných se sníženou odpovědí na glukokortikoidy či při nemožnosti použití adekvátních dávek. Na základě některých společných etiopatogenetických mechanismů byla zkoumána i možnost úspěšného použití chorobu modifikujících chemických i biologických léků revmatoidní artritidy i u revmatické polymyalgie.

Both polymyalgia rheumatica (PMR) and giant-cell arteritis (temporal arteritis, TA) relatively often affect people in old age, have an acute course and cause significant functional impairment. Manifestations of PMR can often resemble those of rheumatoid arthritis (RA). Thus, to differentiate these conditions may be uneasy. In terms of treatment, RA can be treated with chemical agents, disease modifying antirheumatic drugs and glucocorticoids as well as biological agents.Whereas in PMR, glucocorticoid therapy, associated with the side effect burden, is still the only successful treatment. The use of immunosuppressive therapy appears to be effective in patients with diminished response to glucocorticoids or an inability to use the adequate doses. Considering some common etiopathogenetic mechanisms of these two conditions the efficacy of disease modifying chemical and biological agents of rheumatoid arthritis has also been investigated in polymyalgia rheumatica.

MeSH
Antirheumatic Agents classification MeSH
Temporal Arteries pathology MeSH
Biological Therapy * MeSH
Diagnosis, Differential MeSH
Glucocorticoids administration & dosage adverse effects therapeutic use MeSH
Immunoglobulin G pharmacology MeSH
Immunosuppression Therapy MeSH
Clinical Trials as Topic MeSH
Humans MeSH
Methotrexate pharmacology MeSH
Antibodies, Monoclonal pharmacology MeSH
Polymyalgia Rheumatica * diagnosis epidemiology etiology drug therapy pathology MeSH
Prednisone pharmacology MeSH
Inflammation drug therapy MeSH
Check Tag
Humans MeSH
Publication type
Research Support, Non-U.S. Gov't MeSH
Review MeSH

Online article

Pentosidine, an advanced glycation end-product, may reflect clinical and morphological features of hand osteoarthritis

The open rheumatology journal. 2012 ; 6 () : 64-9.

Open Rheumatol J
ISSN 1874-3129
Medvik
Source

The study investigates pentosidine levels, an advanced glycation end-product, in patients with erosive and non-erosive hand osteoarthritis (HOA) and determine its potential association with clinical findings and imaging-defined joint damage.Pentosidine was measured by HPLC in serum and urine of 53 females with HOA (31 erosive and 22 non-erosive HOA) and normalised to the total serum protein or urinary creatinine, respectively. Pain, joint stiffness and disability were assessed by the Australian/Canadian OA hand index (AUSCAN). The hand radiographs scored according to the Kallman grading scale were assessed to determine a baseline value and reassessed after two years.The levels of urine pentosidine, but not of serum pentosidine, were higher in patients with erosive HOA than in non-erosive HOA (p=0.039). Urinary pentosidine correlated with CRP (r=0.302, p=0.031), ESR (r=0.288, p=0.041) and AUSCAN (r=0.408, p=0.003). Serum pentosidine, but not in urine, significantly correlated with the Kallman radiographic score in erosive HOA at the baseline (r=0.409, p=0.022) and after 2 years (r=0.385, p=0.032). However, when corrected for age and disease duration, only correlation between urine pentosidine and AUSCAN remained significant (r=0.397, p=0.004).Our data suggest that serum and urine pentosidine levels may relate to the distinctive clinical and morphological features of HOA.