Rapid and Sustained Response to Tocilizumab in Patients with Polymyalgia Rheumatica Resistant or Intolerant to Glucocorticoids: A Multicenter Open-label Study
Bibliographic record
Abstract
To the Editor: Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disease affecting people aged 50 years or older. PMR usually improves with glucocorticoids (GC), with rapid resolution of symptoms in response to 15–20 mg/day prednisone1. However, around half of the patients with PMR experience a flare of disease when GC are tapered or stopped, and these patients may require longterm GC treatment because of repeated relapses, leading to undesirable side effects. In addition, some patients with PMR have a partial response or do not respond to initial GC treatment1. In this setting, alternative treatments, namely GC-sparing agents, are required. Methotrexate gave conflicting results in PMR while tumor necrosis factor-α inhibitors failed to prevent relapses in randomized controlled studies. Data suggest that interleukin 6 (IL-6) contributes to the inflammatory process of PMR2: Increased serum levels of IL-6 have been described in PMR and correlate with disease activity3; the risk of recurrence/relapse of PMR is associated with persistent elevated IL-6 serum levels as well as with a genetic polymorphism of the IL-6 promoter gene3; and reports described the efficacy of tocilizumab (TCZ), an anti-IL-6 receptor agent, in the treatment of giant cell arteritis (GCA)4,5. The clinical value of TCZ in isolated PMR is less well described. … Address correspondence to Dr. Eric Toussirot, University Hospital, Clinical Investigation Center-Biotherapy, CHU Hopital St Jacques, Bat St Joseph, Besançon, 25000, France. E-mail: etoussirot{at}chu-besancon.fr
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".