Relapses of pain syndrome in patients with polymyalgia rheumatica during reduction of glucocorticoid therapy

An analysis of causes leading to pain recurrence in patients with polymyalgia rheumatica (PR) after tapering down the dose of glucocorticosteroids (GCS) is presented. True exacerbations resulting from the main disease recurrence and pseudo-exacerbations when the resumption of pain syndrome is not du...

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Main Author: N.   V. Bunchuk
Format: Article
Language:Russian
Published: ABV-press 2023-02-01
Series:Klinicist
Subjects:
Online Access:https://klinitsist.abvpress.ru/Klin/article/view/512
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author N.   V. Bunchuk
author_facet N.   V. Bunchuk
author_sort N.   V. Bunchuk
collection DOAJ
description An analysis of causes leading to pain recurrence in patients with polymyalgia rheumatica (PR) after tapering down the dose of glucocorticosteroids (GCS) is presented. True exacerbations resulting from the main disease recurrence and pseudo-exacerbations when the resumption of pain syndrome is not due inflammation but because of other causes – steroid myopathy or chronic adrenal insufficiency (AI) are identified. The experience of using tocilizumab, an inhibitor of interleukin-6 receptors, as steroid-sparing agent in patients with PR is considered. The factors contributing to pain syndrome development, which can mimic exacerbations of PR (associated myofascial pain, vitamin D deficiency, etc.) are indicated. The methodology for AI diagnosis in patients receiving GCS therapy is discussed in detail. Recommendations for the rational AI therapy including acute cases are given.
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issn 1818-8338
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spelling doaj-art-0971b9f651da405a8e7eb75ba8db1a622025-08-20T03:39:14ZrusABV-pressKlinicist1818-83382023-02-01164273210.17650/1818-8338-2022-16-4-K670391Relapses of pain syndrome in patients with polymyalgia rheumatica during reduction of glucocorticoid therapyN.   V. Bunchuk0The Cecil+ ClinicAn analysis of causes leading to pain recurrence in patients with polymyalgia rheumatica (PR) after tapering down the dose of glucocorticosteroids (GCS) is presented. True exacerbations resulting from the main disease recurrence and pseudo-exacerbations when the resumption of pain syndrome is not due inflammation but because of other causes – steroid myopathy or chronic adrenal insufficiency (AI) are identified. The experience of using tocilizumab, an inhibitor of interleukin-6 receptors, as steroid-sparing agent in patients with PR is considered. The factors contributing to pain syndrome development, which can mimic exacerbations of PR (associated myofascial pain, vitamin D deficiency, etc.) are indicated. The methodology for AI diagnosis in patients receiving GCS therapy is discussed in detail. Recommendations for the rational AI therapy including acute cases are given.https://klinitsist.abvpress.ru/Klin/article/view/512polymyalgia rheumaticaglucocorticoid treatmenttocilizumabchronic adrenal insufficiencysteroid myopathy
spellingShingle N.   V. Bunchuk
Relapses of pain syndrome in patients with polymyalgia rheumatica during reduction of glucocorticoid therapy
Klinicist
polymyalgia rheumatica
glucocorticoid treatment
tocilizumab
chronic adrenal insufficiency
steroid myopathy
title Relapses of pain syndrome in patients with polymyalgia rheumatica during reduction of glucocorticoid therapy
title_full Relapses of pain syndrome in patients with polymyalgia rheumatica during reduction of glucocorticoid therapy
title_fullStr Relapses of pain syndrome in patients with polymyalgia rheumatica during reduction of glucocorticoid therapy
title_full_unstemmed Relapses of pain syndrome in patients with polymyalgia rheumatica during reduction of glucocorticoid therapy
title_short Relapses of pain syndrome in patients with polymyalgia rheumatica during reduction of glucocorticoid therapy
title_sort relapses of pain syndrome in patients with polymyalgia rheumatica during reduction of glucocorticoid therapy
topic polymyalgia rheumatica
glucocorticoid treatment
tocilizumab
chronic adrenal insufficiency
steroid myopathy
url https://klinitsist.abvpress.ru/Klin/article/view/512
work_keys_str_mv AT nvbunchuk relapsesofpainsyndromeinpatientswithpolymyalgiarheumaticaduringreductionofglucocorticoidtherapy