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Comment
. 2021 Jul;41(7):1371-1372.
doi: 10.1007/s00296-021-04856-w. Epub 2021 Apr 15.

Does methotrexate have no beneficial effect in reducing flares in the treatment of polymyalgia rheumatica patients?

Sho Matsushita  1 , Shunsuke Taito  2   3 , Norio Yamamoto  3   4
Affiliations
Comment

Does methotrexate have no beneficial effect in reducing flares in the treatment of polymyalgia rheumatica patients?

Sho Matsushita et al. Rheumatol Int. 2021 Jul.

Abstract

We read the article by Marsman et al. regarding the efficacy of methotrexate (MTX) in the treatment of polymyalgia rheumatica (PMR) with great interest. This study added new insights regarding the use of MTX in a real-world clinical setting and its effect on the incidence rates of flares. However, we would like to voice our concerns regarding the definition of the participants and interventions that were performed in the study, as well as the comparability of the intervention and control groups. Our concerns include the possibility of the inadvertent enrollment of patients with rheumatoid arthritis in a study on PMR, a lack of a clear definition of glucocorticoid ineffectiveness, a lack of adjustment of glucocorticoid dosages, and a reliance on the judgement of individual medical providers rather than clearly defined investigative guidelines in the study procedures. To summarize, we would like to voice concerns about how and to whom MTX was prescribed, as well as the definition of the control group. These revisions and modifications would clarify the importance of the results regarding the efficacy of MTX administration in the treatment of PMR.

Keywords: Flare; Glucocorticoid tapering; Methotrexate; Polymyalgia rheumatica.

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References

    1. Marsman D, Bolhuis T, Broeder ND, van den Hoogen F, den Broeder A, van der Maas A (2021) Effect of add-on methotrexate in polymyalgia rheumatica patients flaring on glucocorticoids tapering: a retrospective study. Rheumatol Int 41:611–616. https://doi.org/10.1007/s00296-020-04783-2 - DOI - PubMed
    1. Dejaco C, Singh YP et al (2015) European League Against Rheumatism, American College of Rheumatology 2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 74:1799–1807. https://doi.org/10.1136/annrheumdis-2015-207492 - DOI - PubMed
    1. Caporali R, Montecucco C, Epis O, Bobbio-Pallavicini F, Maio T, Cimmino MA (2001) Presenting features of polymyalgia rheumatica (PMR) and rheumatoid arthritis with PMR-like onset: a prospective study. Ann Rheum Dis 60:1021–1024. https://doi.org/10.1136/ard.60.11.1021 - DOI - PubMed - PMC
    1. Dasgupta B, Cimmino MA et al (2012) 2012 Provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 71:484–942. https://doi.org/10.1136/annrheumdis-2011-200329 - DOI - PubMed - PMC
    1. Pease CT, Haugeberg G, Montague B, Hensor EM, Bhakta BB, Thomson W, Ollier WE, Morgan AW (2009) Polymyalgia rheumatica can be distinguished from late onset rheumatoid arthritis at baseline: results of a 5-yr prospective study. Rheumatology (Oxford) 48:123–127. https://doi.org/10.1093/rheumatology/ken343 - DOI - PubMed

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