{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:56:45Z","timestamp":1792789005088,"version":"4.5.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":80,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The need for glucocorticoid-sparing drugs (GCSD) remains an important issue and is an unmet need in the treatment of polymyalgia rheumatica (PMR). We therefore aimed to assess the effectiveness and safety of methotrexate (MTX) and of leflunomide (LEF) in daily clinical practice in PMR patients from Argentina.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicentre and observational study (medical records review) of PMR patients seen between 2007 and 2023, who had at least three months of follow-up after starting a GCSD, either MTX or LEF, was performed. Results are expressed as medians and interquartile ranges [25th\u201375th (IQR)] for continuous variables and percentages for categorical ones. The two treatment groups were compared using \u03c72 test for categorical variables, Mann\u2013Whitney U test for continuous variables and the log-rank test for time-to-event data. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression. In all cases, a p-value &amp;lt;0.05 was considered statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One-hundred and eighty-six patients (79% female) with a median age of 72\u2009years (IQR, 65\u201377\u2009years) were included. One-hundred and forty-three patients (77%) were prescribed MTX (15, IQR 10\u201315) and 43 (23%) LEF (20\u2009mg, fixed dose). Flare-ups (relapses and recurrences) occurred in 13 patients (7%) and were comparable between both groups. Persistent GCSD intake was observed in 145 patients (78%). Glucocorticoid (GC) withdrawal was achieved in 67 of these 145 patients (46%) and this occurred more frequently in the LEF group (P\u2009=\u20090.001). Furthermore, time until prednisone discontinuation was shorter in the LEF-treated patients (4.7\u2009months, IQR 3\u201320 on LEF versus 31.8\u2009months, IQR 10\u201382 on MTX, P\u2009=\u20090.000). Remission was found more frequently in the LEF group (P\u2009=\u20090.003). In the multivariate analysis, the probability of remission was higher with LEF therapy (P\u2009=\u20090.010) and this finding persisted in the subgroup analysis who were followed up &amp;lt; 40\u2009months (OR 3.12, 95% CI\u2009=\u20091.30\u20137.47, P\u2009=\u20090.011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrated the clinical effectiveness of LEF and even its superiority in achieving remission when compared with MTX as GCSD in PMR patients. Further research is needed to support these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rap\/rkae033","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T19:18:02Z","timestamp":1710875882000},"source":"Crossref","is-referenced-by-count":21,"title":["Effectiveness of methotrexate and leflunomide as corticoid-sparing drugs in patients with polymyalgia rheumatica"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4820-0023","authenticated-orcid":false,"given":"Juan Pablo","family":"Vinicki","sequence":"first","affiliation":[{"name":"Secci\u00f3n Reumatolog\u00eda, Hospital de Quilmes , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Cusa","sequence":"additional","affiliation":[{"name":"IARI , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Domingo","sequence":"additional","affiliation":[{"name":"HIGA Luisa Cravenna de Gandulfo , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Velasco Zamora","sequence":"additional","affiliation":[{"name":"Instituto de Investigaciones Cl\u00ednicas de Quilmes , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebasti\u00e1n","family":"Magri","sequence":"additional","affiliation":[{"name":"Unidad de Reumatolog\u00eda, Hospital Italiano de La Plata , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Brigante","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, Sanatorio G\u00fcemes , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Marcela","family":"Schmid","sequence":"additional","affiliation":[{"name":"Secci\u00f3n Reumatolog\u00eda, Hospital Llano , Corrientes, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"\u00c1vila","sequence":"additional","affiliation":[{"name":"Secci\u00f3n Reumatolog\u00eda, Hospital de Quilmes , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Zamora","sequence":"additional","affiliation":[{"name":"Secci\u00f3n Reumatolog\u00eda, HIGA San Jos\u00e9 , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Sorrentino","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, Sanatorio G\u00fcemes , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anabella M","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"CEMIC, Secci\u00f3n Reumatolog\u00eda e Inmunolog\u00eda , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Linarez","sequence":"additional","affiliation":[{"name":"OSPM, Unidad de Reumatolog\u00eda , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Pisoni","sequence":"additional","affiliation":[{"name":"CEMIC, Secci\u00f3n Reumatolog\u00eda e Inmunolog\u00eda , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Costi","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, HIGA San Mart\u00edn de La Plata , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Rodriguez Gil","sequence":"additional","affiliation":[{"name":"Unidad de Reumatolog\u00eda, Hosp\u00edtal Municipal Dr Le\u00f3nidas Lucero , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Andrea","family":"Spinetto","sequence":"additional","affiliation":[{"name":"Centro M\u00e9dico Privado , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanesa Ursula","family":"Paris","sequence":"additional","affiliation":[{"name":"Unidad de Reumatolog\u00eda, Hospital Escuela de Agudos Dr Ram\u00f3n Madariaga , Misiones, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Perrotta","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, Hospital Dr C\u00e9sar Milstein , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda del Rosario","family":"Maliandi","sequence":"additional","affiliation":[{"name":"Unidad de Reumatolog\u00eda, Sanatorio Garay , Santa Fe, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Rillo","sequence":"additional","affiliation":[{"name":"Secci\u00f3n Reumatolog\u00eda, Hospital Ignacio Pirovano , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Pena","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, HIGA San Mart\u00edn de La Plata , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Got","sequence":"additional","affiliation":[{"name":"Unidad de Reumatolog\u00eda, Instituto M\u00e9dico HUMANITAS , Chaco, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Cavallasca","sequence":"additional","affiliation":[{"name":"Secci\u00f3n Reumatolog\u00eda, Hospital Jos\u00e9 Bernardo Iturraspe , Santa Fe, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximiliano","family":"Machado Escobar","sequence":"additional","affiliation":[{"name":"Secci\u00f3n Reumatolog\u00eda, Hospital Eva Per\u00f3n , Tucum\u00e1n, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Iturralde","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, HIGA Dr Oscar Alende , Mar del Plata, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6797-4553","authenticated-orcid":false,"given":"Mar\u00eda Victoria","family":"Martire","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, HIGA San Roque de Gonnet de La Plata , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Tessel","sequence":"additional","affiliation":[{"name":"Servicio de Reumatolog\u00eda, Hospital Se\u00f1or del Milagro , Salta, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N Saravia","family":"Chocobar","sequence":"additional","affiliation":[{"name":"Secci\u00f3n Reumatolog\u00eda, Hospital de Quilmes , Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciela","family":"Alarcon","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Rheumatology, Department of Medicine, Marnix E. Heersink School of Medicine, The University of Alabama at Birmingham , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"key":"2024032903405880100_rkae033-B1","doi-asserted-by":"crossref","first-page":"672","DOI":"10.7326\/0003-4819-97-5-672","article-title":"Polymyalgia rheumatica: a 10-year epidemiologic and clinical study","volume":"97","author":"Chuang","year":"1982","journal-title":"Ann Intern Med"},{"key":"2024032903405880100_rkae033-B2","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1136\/ard.48.8.658","article-title":"Treatment of polymyalgia rheumatica and giant cell arteritis. I. 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