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Traditional and Emerging Strategies for Managing Polymyalgia Rheumatica: Insights into New Treatments
Carlos García-Porrúa1, Elena Heras-Recuero2, Teresa Blázquez-Sánchez2
1Division of Rheumatology, Hospital Lucus-Augusti, 27003 Lugo, Spain.
Journal of Clinical Medicine
|November 9, 2024
Summary
Glucocorticoids are standard for Polymyalgia Rheumatica (PMR), but side effects and relapses are common. Glucocorticoid-sparing agents, like biologics tocilizumab and sarilumab, show promise in managing PMR and reducing steroid dependence.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Polymyalgia Rheumatica (PMR) is an inflammatory condition affecting older adults.
- Glucocorticoids are primary treatment but cause side effects and relapses upon tapering.
- Need for effective, steroid-sparing therapies in PMR management.
Purpose of the Study:
- Review traditional PMR management.
- Evaluate therapies aimed at reducing glucocorticoid use.
- Assess the efficacy of biologic agents in PMR treatment.
Main Methods:
- Literature review of PubMed articles.
- Analysis of glucocorticoids and conventional disease-modifying antirheumatic drugs (DMARDs).
- Focus on new therapies, particularly biologic agents for PMR.
Main Results:
- Prednisone/prednisolone (12.5-25 mg/day) is standard PMR treatment.
- Methotrexate is a recommended conventional DMARD; leflunomide shows potential.
- Anti-IL-6 receptor biologics (tocilizumab, sarilumab) reduce relapses and glucocorticoid burden.
Conclusions:
- Glucocorticoids are effective but linked to comorbidities in PMR.
- Methotrexate and biologics offer steroid-sparing alternatives.
- Biologics improve PMR remission but require cost-benefit analysis.
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