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Polymyalgia Rheumatica

First described in 1888, polymyalgia rheumatica (PMR) is a chronic inflammatory condition that almost exclusively affects individuals older than 50. A new generation of intrepid researchers and clinicians is learning more and more about all aspects of PMR. Much of the old dogma is being thrown out and replaced with a more nuanced understanding of what it means to carry the diagnosis. In this the article collection, we review the details of such new thinking.

Article collection made possible by Sanofi and Regeneron Pharmaceuticals Inc. The sponsor did not participate in the development of the supplement or play any role in the article selection.

FEATURED ARTICLE: Polymyalgia Rheumatica: New Tricks for an Old Disease

Research, News, Case Reports & More

Polymyalgia Rheumatica: New Tricks for an Old Disease

Desh Nepal, MD, Sebastian E. Sattui, MD, MS, & Michael Putman, MD, MS  |  

Originally posted Feb. 13, 2023; reposted in conjunction with publication of the PMR supplement to the February 2024 issue of The Rheumatologist. PHILADELPHIA—Polymyalgia rheumatica (PMR) is a chronic inflammatory condition that almost exclusively affects individuals older than 50.1 First described in 1888, PMR has been a recognized rheumatic disease since at least 1957. Diagnosing the…

Study Assesses Sarilumab for Polymyalgia Rheumatica

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In an ACR Convergence 2022 session, Robert Spiera, MD, director of the Scleroderma, Vasculitis, and Myositis Center at the Hospital for Special Surgery, New York City, discussed the use of sarilumab as a potential glucocorticoid-sparing therapy in a phase 3 study in patients with treatment-refractory polymyalgia rheumatica (PMR), one of the most common inflammatory diseases…

FDA Approves Sarilumab for Adults with Glucocorticoid-Resistant Polymyalgia Rheumatica

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On Feb. 28, 2023, the U.S. Food & Drug Administration (FDA) approved sarilumab (Kevzara) for the treatment of adults with polymyalgia rheumatica (PMR) for whom glucocorticoids have proved inadequate or who cannot tolerate a glucocorticoid taper.1,2 Sarilumab is an interleukin (IL) 6 receptor antagonist. In May 2017, the FDA initially approved the agent for the…

How to Treat Refractory Polymyalgia Rheumatica

Katie Robinson  |  

Patients with polymyalgia rheumatica (PMR) who had relapsed while tapering glucocorticoid therapy were more likely to achieve sustained remission at one year and have a lower glucocorticoid exposure if they were treated with sarilumab (Kevzara) plus a rapid, 14-week glucocorticoid taper than if they received placebo plus a standard, 52-week glucocorticoid taper. This is according…

Study: Most Patients with PMR Aren’t Getting Steroid-Sparing Agents in First 2 Years

Katie Robinson  |  

A minority of patients with polymyalgia rheumatica (PMR) who were new to rheumatology practice were prescribed steroid-sparing agents through two years of follow-up. This is according to a large, U.S.-based cohort study, published in Arthritis Care & Research, which also found that nearly two-thirds of the patients remained on glucocorticoids beyond one year.1 “Our study…

Study Probes Corticosteroid Dependence in Polymyalgia Rheumatica

Vivekanand Tiwari, MD, Emily Campbell, MD, Joshua Skydel, MD, Bryan Savage, MD, Monica Dimambro, Todd MacKenzie, PhD, & William F. Rigby, MD  |  

Background/Purpose Polymyalgia rheumatica (PMR) treatment is primarily based on long-term corticosteroids, which results in significant toxicities. Studies have shown that patients with PMR are exposed to years of corticosteroid treatment.1,2 In a single academic center cohort, we found that 76% of patients remained on steroids at the end of two years.3 In a second cohort…

How Prevalent Is Subclinical Giant Cell Arteritis in Polymyalgia Rheumatica?

Colm Kirby, MB, BCh, BAO, MRCPI, Rachael Flood, MB, BCh, BAO, MRCPI, Ronan Mullan, MB, BCh, BAO, MRCPI, Grainne Murphy, MB, BCh, BAO, MRCPI, & David Kane, MB, BCh, BAO, MRCPI  |  

Background/Purpose It has been reported that 20–50% of patients with polymyalgia rheumatica (PMR) have subclinical giant cell arteritis (GCA). The natural history of ultrasound-defined subclinical GCA in PMR is not known. Methods Twenty-five newly diagnosed PMR patients who met a clinical diagnosis for PMR, verified by two rheumatologists, were examined by ultrasound. All six branches…

Study: Patients with PMR Experience Fatigue, Sleep Disturbance & Mood Disorders

Jessica Leung, MBBS, FRACP, Claire E. Owen, MBBS, PhD, FRACP, David Liew, MBBS, FRACP, & Russell Buchanan, MBBS, MD, FRACP  |  

Background/Purpose Polymyalgia rheumatica (PMR) is typified by pain and stiffness of the shoulder and hip girdles. Previous qualitative studies have highlighted the importance to patients of additional symptoms, including fatigue and sleep disturbance. These features of PMR are less recognized by clinicians and have not yet been quantified in the literature. Further, the adequacy of…

The Great Debate 2023

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SAN DIEGO—Panelists at ACR Convergence 2023 debate the merits of IL-6 inhibitors vs. glucocorticoids for the initial treatment of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR).