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Response to 'Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial'

Pippa Watson* and Hill Gaston

Author Affiliations

Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, UK

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Arthritis Research & Therapy 2011, 13:403  doi:10.1186/ar3269

See related research by Kreiner and Galbo,

Published: 6 April 2011

First paragraph (this article has no abstract)

We read with interest the article recently published in Arthritis Research & Therapy by Kreiner and Galbo [1] that reported a very modest benefit of etanercept monotherapy in polymyalgia rheumatica (PMR). There is some evidence that TNFα can be found in the lesions of giant cell arteritis (GCA) [2]. However, two previous randomised controlled trials [3,4] showed no benefi t of TNFα inhibition in the treatment of PMR/GCA. We report for the first time the development of PMR and GCA in two patients undergoing treatment with anti- TNFα drugs. This suggests that the underlying immunopathology of GCA/PMR is not driven by TNFα and casts further doubt on the likely usefulness of TNFα blockade in these conditions.