Abstract
Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are closely related chronic inflammatory diseases. Glucocorticoids (GCs) are first-choice drugs for PMR and GCA, although some patients show poor responsiveness to the initial GC regimen or experience flares after GC tapering. To date, no valid biomarkers have been found to predict which patients are at most risk for developing GC resistance. In this review, we summarize PMR- and GCA-related gene polymorphisms and we associate these gene variants with GC resistance and therapeutic outcomes. A limited number of GC resistance associated-polymorphisms have been published so far, mostly related to HLA-DRB1*04 allele. Other genes such ICAM-1, TLR4 and 9, VEGF, and INFG may play a role, although discrepancies are often found among different populations. We conclude that more studies are required to identify reliable biomarkers of GC resistance. Such biomarkers could help distinguish non-responders from responders to GC treatment, with concomitant consequences for therapeutic strategy.
Highlights
Controversy remains as to whether polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are two different pathological conditions or manifestations of a single disease
We found no other studies dealing with GC resistance and Glucocorticoid receptor (GR)-related polymorphisms in the treatment of PMR and GCA
According to the results obtained from the study with PMR patients of Italian origin, no significant association was observed between the chemokine receptor 5 (CCR5) genotype and the therapeutic outcomes measured as duration of therapy, frequency of relapse/recurrence, as well as the initial and cumulative prednisone dose [69]
Summary
Controversy remains as to whether polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are two different pathological conditions or manifestations of a single disease. They often overlap in the same patient and affect the same population. In accordance with PMR/GCA overlapping, using PET scans showed that a one-third of apparently isolated PMR patients suffer from inflammatory vessel involvement or clinically unrecognized GCA [3,4,5] Both PMR and GCA only share common clinical characteristics such as an increase in acute phase reactants reflecting systemic inflammation as well as responsiveness to corticosteroids [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
