Successful add-on clarithromycin treatment for polymyalgia rheumatica

Yıl 2022, Cilt: 1 Sayı: 1, 32 - 36, 28.09.2022

Masashi Ohe

https://doi.org/10.5505/achmedj.2022.24865

Öz

Macrolide antibiotics (MACs) such as erythromycin and clarithromycin (CAM) provide not only anti-bacterial activity but also anti-inflammatory and immunomodulatory effects. Considering anti-inflammatory effects, several recent studies have reported the successful treatments of rheumatoid arthritis and polymyalgia rheumatica (PMR) treated using CAM. Herein, we also report another case of patient with PMR treated using CAM. A 72-year-old woman with PMR was treated using prednisolone (PSL) (20 mg/day). When muscle pain disappeared and C-reactive protein (CRP) decreased, the PSL dosage was gradually reduced without any sign of recurrence. When the PSL dosage was decreased to 5 mg/day, muscle pain returned, and CRP was increased. The PSL dosage was successfully increased to 8 mg/day. The PSL dosage was gradually decreased without any sign of recurrence. When the PSL dosage was again decreased to 5 mg/day, muscle pain returned, and CRP increased. There was no significant finding in the examinations made especially for accompanying giant cell arteritis. As an alternative to increasing the PSL dosage, CAM was added. About four weeks after CAM treatment, the muscle pain disappeared, and CRP became negative. This case suggests tha

Anahtar Kelimeler

Polymyalgia rheumatica, Prednisolone, Clarithromycin