Polymyalgia Rheumatica and Giant Cell Arteritis: A Geriatric Perspective

Area of Science:

• Rheumatology
• Geriatric Medicine
• Internal Medicine

Background:

• Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are common inflammatory conditions in older adults.
• Diagnosis can be challenging due to overlapping symptoms and the need for definitive confirmation, especially for GCA.
• This study focuses on the geriatric population, addressing diagnostic and treatment complexities.

Purpose of the Study:

• To evaluate the clinical presentation of PMR and GCA in elderly patients.
• To compare diagnostic approaches, including clinical, laboratory, and histopathological methods.
• To assess treatment outcomes and adverse effects of therapies in geriatric patients.

Main Methods:

• A cross-sectional study involving 118 patients aged 50+ diagnosed with PMR and/or GCA.
• Data collected via interviews, medical records, and diagnostic reports.
• Statistical analysis of clinical characteristics, lab markers, and treatment responses.

Main Results:

• PMR diagnosis relied on clinical symptoms and elevated inflammatory markers (CRP/ESR).
• Giant cell arteritis (GCA) was confirmed by temporal artery biopsy (TAB) in 76% of suspected cases; vascular ultrasound showed the "halo sign" in 67%.
• Glucocorticoids achieved remission in 84% but caused hyperglycemia (28%) and osteoporosis (14%); delayed treatment increased relapse rates (p=0.04).

Conclusions:

• Glucocorticoid therapy is effective but requires monitoring for adverse effects like hyperglycemia and osteoporosis.
• Tocilizumab use was associated with higher relapse and metabolic complications.
• Personalized treatment strategies and steroid-sparing options are essential for long-term management of PMR and GCA in the elderly.