Clarithromycin treatment for polymyalgia rheumatica

Abstract

Macrolide antibiotics, such as clarithromycin (CAM), provide not only antibacterial activity but also anti-inflammatory effects. Several recent studies have reported the successful treatment of rheumatoid arthritis and polymyalgia rheumatic (PMR) using CAM due to its anti-inflammatory effects. Herein, we also report two cases of PMR treated using CAM. Case 1: An 83-year-old man with PMR was treated using prednisolone (PSL) (15 mg/day) and CAM. When muscle pain disappeared and C-reactive protein (CRP) decreased, the PSL dosage was reduced. When PSL was reduced to 5 mg/day, CAM was discontinued. However, following this discontinuation, muscle pain returned and CRP became positive. Therefore, CAM was successfully readministered. Case 2: A 68-year-old woman with PMR was treated using PSL (15 mg/day). When muscle pain disappeared and CRP decreased, the PSL dosage was reduced. When PSL was reduced to 7 mg/day, muscle pain returned, and CRP became positive. CAM was successfully added and the PSL dosage could be decreased to 5 mg/day. These two cases suggest that treatment using CAM may be effective in some cases of PMR.