#3-99E. Modern Management of Polymyalgia Rheumatica and the Role of IL-6 Inhibitors (NEJM, 2026)

How should clinicians manage severe bilateral shoulder pain and morning stiffness in older adults while minimizing the risks of long-term glucocorticoid therapy? This episode delves into a comprehensive clinical review on polymyalgia rheumatica (PMR), an inflammatory condition typically affecting individuals over fifty. The paper outlines the diagnostic approach, primarily based on hallmark clinical symptoms and elevated inflammatory markers, and discusses current treatment paradigms1more_horiz. The most critical clinical takeaway is the emerging efficacy of interleukin-6 (IL-6) receptor inhibitors, such as sarilumab and tocilizumab, as vital steroid-sparing agents. This represents a significant shift in minimizing cumulative glucocorticoid exposure and managing frequent disease relapses. However, when critically appraising this review, it is important to note that PMR still lacks a specific diagnostic biomarker, and current glucocorticoid dosing and tapering protocols rely heavily on expert consensus rather than robust clinical trial data. For practicing physicians, this article is highly relevant; it provides updated, actionable strategies to combat steroid dependence and mitigate adverse effects in daily practice, ultimately improving the long-term care of aging patients with PMR.

Citation: Dejaco C, Matteson EL. Polymyalgia Rheumatica. New England Journal of Medicine. 2026. DOI: 10.1056/NEJMcp2506817112

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.