Current Insights and Future Perspectives for the Use of Serological Biomarkers in Polymyalgia Rheumatica

There is currently no gold standard diagnostic test or validated serological biomarker to monitor disease activity or inform disease prognostication in isolated Polymyalgia Rheumatica (PMR). This presents significant challenges as the diagnosis of PMR is often complicated by multiple disease mimics, and the disease course remains highly variable, with no way to predict who will experience multiple disease relapses and high cumulative glucocorticoid burden. Furthermore, with the expansion of the therapeutic armamentarium of PMR, it is evident that our current one size fits all management strategy is no longer sufficient. In this narrative review, we summarise recent studies evaluating serological biomarkers for the diagnosis and prognostication of PMR, as well as their roles in disease activity monitoring and in identifying concomitant giant cell arteritis. We discuss their limitations, and explore barriers to their clinical translation, and finally highlight key directions for future research studies.