You are here

Article Text

Article menu

Download PDFPDF

Editorial
Interleukin-6: a promising target for the treatment of polymyalgia rheumatica or giant cell arteritis?
  1. Éric Toussirot1,2,3,4,
  2. Alexis Régent5,6,
  3. Valérie Devauchelle-Pensec7,
  4. Alain Saraux7 and
  5. Xavier Puéchal6
  1. 1Clinical Investigation Centre Biotherapy INSERM CIC-1431, University Hospital of Besançon, Besançon, France
  2. 2Fédération Hospitalo-Universitaire INCREASE, University Hospital of Besançon, Besançon, France
  3. 3Department of Rheumatology, University Hospital of Besançon, Besançon, France
  4. 4Department of Therapeutics and UPRES EA 4266 « Agents Pathogènes et Inflammation», University of Bourgogne Franche-Comté, Besançon, France
  5. 5Paris-Descartes University, Paris, France
  6. 6Department of Internal Medicine, Centre de référence maladies auto-immunes et systémiques rares, Hôpital Cochin, AP-HP, Paris, France
  7. 7Department of Rheumatology, University Hospital of Brest, Brest, France
  1. Correspondence to Professor Éric Toussirot; etoussirot{at}chu-besancon.fr

https://doi.org/10.1136/rmdopen-2016-000305

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Polymyalgia rheumatica (PMR) is a chronic inflammatory disease of unknown aetiology affecting people aged over 50. The hallmark manifestations of PMR are pain and stiffness affecting the neck and shoulder and pelvic girdles. There is no specific laboratory test for the disease, and thus the diagnosis of PMR depends on a combination of clinical symptoms, raised acute phase reactants, the exclusion of other diagnoses and response to glucocorticoids (GCs).1 For classification purposes, a number of criteria have been proposed and the most recent were collectively drawn up by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR).2

    Giant cell arteritis (GCA) is a type of vasculitis of large-sized and medium-sized arteries affecting people aged over 50. The disease usually involves aorta, supra-aortic branches and the extracranial branches of the carotid artery. The clinical manifestations include headaches, temporal artery or scalp tenderness, jaw claudication, visual symptoms, constitutional symptoms and PMR manifestations.3 At the time of diagnosis, the most serious consequence of GCA is the occurrence of visual loss in 12–14% of patients.4 Aortic aneurysm or dissection may develop during follow-up and can be potentially life-threatening. The gold standard for the diagnosis of GCA remains temporal artery biopsy (TAB). Approximately 60–80% of TABs show evidence of vasculitis with a mononuclear cell infiltrate, disruption of the internal elastic lamina and multinucleated giant cells, the hallmark of the disease, in ∼50% of patients.5 However, ACR classification criteria were developed in patients who already have evidence of vasculitis and do not take into account the additional value of imaging techniques.6 Indeed, ultrasonography of TAB may reveal a hypoechoic halo sign and is considered to be highly specific for GCA diagnosis despite interobserver and interstudy discrepancies.7 In addition, positron emission tomography (PET) is a valuable …

    View Full Text