Pachydermoperiostosis (PDP), also known as Touraine-Solente-Golé syndrome or primary hypertrophic osteoarthropathy, is a rare syndrome that can be inherited as autosomal dominant, autosomal recessive, or sporadically. This progressive disease primarily affects males, who tend to have more severe features than females. PDP usually occurs during adolescence, often starting around puberty.1 The main clinical features are…
Mental Health in Rheumatology
Regaining a sense of control, limiting responsibilities and engaging in mindfulness can help rheumatologists manage their mental health needs. Rheumatologists should also address the mental health concerns raised by their patients. Here are insights from a psychiatrist/rheumatologist.
Curbside Consults: Experts Weigh in on Complex Rheumatic Conditions
In this ACR Convergence 2023 session, experts offered guidance on a selection of diagnostic & treatment challenges rheumatologists may encounter.
3 AC&R Study Summaries: Prescribing Patterns, PMR & Glucocorticoids, & Infection Screening
A Shift in Prescribing Patterns Safety issues prompt discontinuation of tofacitinib By Stephanie Song, MD, & Joshua F. Baker, MD, MSCE Why was this study done? The ORAL Surveillance study highlighted risks of cardiac events, thromboembolism (VTE) and malignancy associated with use of Janus kinase inhibitors (JAKi). We sought to determine the impact of safety…
New Ways to Think about Polymyalgia Rheumatica
As they usually are, the pediatrics are absolutely correct: A child is not just a little adult. The same can be said for the eldest among us: Senior citizens are more than just old adults; they have their own biopsychosocial considerations that we, as rheumatologists, must tend to. Among all the conditions that we find…
Study Assesses Sarilumab for Polymyalgia Rheumatica
In an ACR Convergence 2022 session, Robert Spiera, MD, director of the Scleroderma, Vasculitis, and Myositis Center at the Hospital for Special Surgery, New York City, discussed the use of sarilumab as a potential glucocorticoid-sparing therapy in a phase 3 study in patients with treatment-refractory polymyalgia rheumatica (PMR), one of the most common inflammatory diseases…
FDA Approves Sarilumab for Adults with Glucocorticoid-Resistant Polymyalgia Rheumatica
On Feb. 28, 2023, the U.S. Food & Drug Administration (FDA) approved sarilumab (Kevzara) for the treatment of adults with polymyalgia rheumatica (PMR) for whom glucocorticoids have proved inadequate or who cannot tolerate a glucocorticoid taper.1,2 Sarilumab is an interleukin (IL) 6 receptor antagonist. In May 2017, the FDA initially approved the agent for the…
How to Treat Refractory Polymyalgia Rheumatica
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…
Study: Most Patients with PMR Aren’t Getting Steroid-Sparing Agents in First 2 Years
A minority of patients with polymyalgia rheumatica (PMR) who were new to rheumatology practice were prescribed steroid-sparing agents through two years of follow-up. This is according to a large, U.S.-based cohort study, published in Arthritis Care & Research, which also found that nearly two-thirds of the patients remained on glucocorticoids beyond one year.1 “Our study…
Study Probes Corticosteroid Dependence in Polymyalgia Rheumatica
Background/Purpose Polymyalgia rheumatica (PMR) treatment is primarily based on long-term corticosteroids, which results in significant toxicities. Studies have shown that patients with PMR are exposed to years of corticosteroid treatment.1,2 In a single academic center cohort, we found that 76% of patients remained on steroids at the end of two years.3 In a second cohort…
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