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Current Insights and Future Perspectives for the Use of Serological Biomarkers in Polymyalgia Rheumatica
Patricia Harkins1,2, Sharon Cowley2,3, Richard Conway1,2
1Department of Rheumatology, St. James Hospital, Dublin, Ireland.
Abstract:
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.
Insights
Polymyalgia Rheumatica (PMR) lacks reliable biomarkers for diagnosis and monitoring, complicating management. This review explores emerging serological markers to improve PMR patient care and outcomes.
Area of Science:
- Rheumatology
- Immunology
- Clinical Diagnostics
Background:
- Polymyalgia Rheumatica (PMR) diagnosis is challenging due to mimics and variable disease course.
- Current management is insufficient due to lack of prognostic and monitoring tools.
- No validated serological biomarker exists for PMR diagnosis, activity monitoring, or prognostication.
Purpose of the Study:
- To review recent studies on serological biomarkers for PMR diagnosis and prognostication.
- To evaluate biomarkers for monitoring disease activity and identifying Giant Cell Arteritis.
- To discuss limitations and barriers to clinical translation of these biomarkers.
Main Methods:
- Narrative review of recent literature.
- Focus on serological biomarkers.
- Analysis of diagnostic, prognostic, and monitoring applications.
Main Results:
- Several serological biomarkers show potential for PMR diagnosis and monitoring.
- Biomarkers may help differentiate PMR from mimics and predict disease course.
- Identifying concomitant Giant Cell Arteritis is a key application.
Conclusions:
- Validated serological biomarkers are crucial for advancing PMR management.
- Overcoming limitations is key for clinical translation of promising biomarkers.
- Future research should focus on developing and validating reliable biomarkers for PMR.
