09:07 AM

How to Treat Refractory Polymyalgia Rheumatica

The Rheumatologist reports that 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 to a study published in The New England Journal of Medicine. 

“PMR is among the most common inflammatory diseases, and although corticosteroids are extremely effective in controlling disease activity, flares, which generally necessitate raising the corticosteroid dose, are common, meaning that most patients have a prolonged course of treatment,” explains Robert F. Spiera, MD, rheumatologist at HSS. “This results in many corticosteroid-related complications in this vulnerable group of patients. There is a major unmet need for an effective corticosteroid-sparing strategy in this disease, particularly in refractory patients.” Previous studies have implicated IL-6 in the pathophysiology of PMR and suggested that IL-6 inhibition may be clinically useful in treating the condition.

“It is exciting to see an understanding of disease pathophysiology ultimately result in the demonstration of a targeted therapy being effective in a rheumatic disease,” said Dr. Spiera. “This is truly a bench-to-bedside journey, as it has been for many of the other biologics and targeted therapies that have led to improved outcomes for patients with inflammatory and autoimmune diseases. Our improved sophistication in clinical trial design and execution also contributed enormously to the ability to prove this strategy as effective.”

Read the full article at the-rheumatologist.org.