A Targeted Literature Review of the Clinical and Humanistic Burden of Polymyalgia Rheumatica and the Associated Unmet Medical Needs

OBJECTIVES: Polymyalgia Rheumatica (PMR) is an inflammatory disorder characterized by pain and stiffness in the neck, shoulder, and hips affecting people ≥50 years. PMR can cause significant burden impacting patients’ daily lives and overall health. Despite half of patients relapsing within a year and an unfavourable safety profile, glucocorticoids remain the standard of care. This review identified and summarized existing literature on the clinical and humanistic burden, and unmet medical needs associated with PMR.

METHODS: A targeted literature review was conducted in March 2024. Search strategies were applied in MEDLINE, EMBASE, CENTRAL and CDSR. Additionally, hand searches were performed on key congress websites and in bibliographic sources. The selection of studies, data extraction and results summarization followed established and current best practices.

RESULTS: This review included 124 publications. Atypical PMR presentation can lead to misdiagnosis, multiple consultations and referral cycles subsequently resulting in delayed diagnosis (~3 months). PMR patients have an increased risk of cardiometabolic and cardiovascular diseases (CVDs), stroke, fracture, and early-stage cancer. While there is limited evidence to suggest that PMR significantly impacts mortality, CVDs are the leading cause of death in PMR patients. PMR is commonly managed with prolonged use of glucocorticoids, which can lead to AEs such as osteoporosis, diabetes, infections, and CVDs. PMR symptoms (pain, stiffness and fatigue) and glucocorticoid treatment burden impacts patients' ability to carry out daily activities and subsequently impacts QoL, affecting mental health, sleep, social and personal relationships. Unmet needs in PMR include diagnostic delay, lack of effective and safe treatments, and need for glucocorticoid-sparing therapies.

CONCLUSIONS: PMR, considered to be the second most prevalent rheumatic disease after rheumatoid arthritis, is expected to lead to increased disease burden as the population continues to age. This review highlights the significant impact of PMR and the need for effective treatment options with a favourable safety profile.