Response to 'Effect of etanercept in polymyalgia rheumatica: a randomized controlled trial'
Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, UK
Arthritis Research & Therapy 2011, 13:403 doi:10.1186/ar3269
See related research by Kreiner and Galbo, http://arthritis-research.com/content/12/5/R176Published: 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  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) . 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.