Tip sheet for Annals of Internal Medicine -- May 1, 2007, issue

April 30, 2007

Two studies in the May 1, 2007, Annals of Internal Medicine find that infliximab, a widely used anti-tumor necrosis drug, has no benefit in patients receiving standard corticosteroid treatment for giant-cell arteritis (GCA) or polymyalgia rheumatica (PMR). The diseases, common overlapping inflammatory rheumatic diseases of unknown origin, are usually treated with steroids, which can have serious side effects if used for long periods at high doses.

In one study, 44 patients being treated with steroids for newly diagnosed GCA were assigned to receive either infliximab or a placebo (Article, p. 621). All patients followed a schedule to gradually reduce the dose of steroid dose. The study, planned to last 54 weeks, was stopped at 22 weeks because it became clear that infliximab did not prevent relapse of symptoms or reduce the amount off steroids needed to reduce the symptoms.

In another study, 51 patients being treated with corticosteroids for newly diagnosed PMR were assigned to receive either infliximab or a placebo (Article, p. 631). At the end of the 22-week study, infliximab had not prevented relapse of symptoms or reduced the dose of steroids.

An editorial writer says that GCA and polymyalgia rheumatica remain "therapeutic challenges." For now, steroids remain the standard treatment (Editorial, p. 674).
-end-
NOTE: Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information.

American College of Physicians

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