Polymyalgia rheumatica (PMR) is an inflammatory condition affecting adults over 50 — most commonly over 70 — causing aching and stiffness in the shoulders, neck, and hips, typically worst in the morning. It is closely related to giant cell arteritis and can occur together with it. Corticosteroids produce dramatic symptom relief within days, but many patients require long courses with associated side effects including osteoporosis and diabetes.
What's actually going on in research
Prednisone remains the standard treatment, and most patients are treated for one to two years or longer. Up to half of patients relapse during steroid tapering. Tocilizumab (IL-6 receptor inhibitor), already approved for giant cell arteritis, has shown benefit in PMR in trials and is being evaluated to allow faster steroid tapering. Other IL-6 pathway inhibitors and JAK inhibitors are also in trials aiming to reduce total steroid exposure and the associated risks of long-term corticosteroid use.
IL-6 inhibitor therapy
Tocilizumab and sarilumab are in trials for PMR to enable faster, safer corticosteroid tapering and to reduce relapse rates in patients who require prolonged steroid courses.
JAK inhibitors
Oral JAK inhibitors are being explored in PMR as steroid-sparing alternatives that could simplify long-term management and reduce the cumulative burden of corticosteroid side effects.
Relapse prediction
Studies are identifying clinical, imaging, and biomarker predictors of relapse during steroid taper, to guide individualized tapering schedules and pre-emptive biologic use.
What to know before you search
Eligibility typically requires confirmed PMR diagnosis in adults over 50, active disease, and consideration of steroid-sparing need.
What types of trials are currently open
- IL-6 inhibitor trials — Testing tocilizumab and sarilumab to reduce relapse and steroid exposure in active PMR.
- JAK inhibitor trials — Evaluating oral JAK inhibitors as steroid-sparing agents in new-onset and relapsing PMR.
- Steroid tapering strategy trials — Comparing accelerated versus standard prednisone taper schedules with biologic support.
- Biomarker studies — Identifying blood and imaging markers that predict relapse risk to personalize therapy duration.
- Long-term outcome studies — Tracking cardiovascular, bone density, and metabolic outcomes of corticosteroid use in PMR patients.
Recently added Polymyalgia Rheumatica trials
The VGR GCA Cohort: Ultrasound, Biopsy and Biomarkers - Novel Methods for Diagnosis, Monitoring and Prognosis in Giant Cell Arteritis.
Giant cell arteritis (GCA) is the most common vasculitis in the elderly and is usually treated with long-term corticosteroid therapy. Many patients experience relapses and treatment-related side effects. Current diagnostic and monitoring methods provide limited prognostic information and cannot reliably distinguish active from inactive disease during relapse. This project addresses the clinical need for improved tools to identify patients at high risk of relapse and to develop more effective methods for disease monitoring. The aim is to develop new tools that enable more personalized treatment of GCA. By combining vascular ultrasound with novel blood biomarkers, we seek to predict disease course and relapse risk. The specific objectives are: * To identify ultrasound and blood biomarkers that can predict long-term disease control. * To determine which ultrasound parameters and blood biomarkers can distinguish active from inactive disease during treatment. * To evaluate whether extended vascular ultrasound protocols can improve diagnostic accuracy. The ultimate goal is to establish safe, practical tools for improved diagnosis and follow-up in patients with GCA.
Orbital Vascular Inflammation in Ischemic Optic Neuropathy and Giant Cell Arteritis
Giant cell arteritis (GCA) is an inflammation of the blood vessels. A dangerous complication is sudden vision loss due to insufficient blood supply to the optic nerve. However, it is often difficult to distinguish acute vision loss due to GCA from a similar condition of insufficient blood supply to the optic nerve, called NAION. Quick treatment with anti-inflammatory medication is needed in case of GCA to prevent vision loss on the eye and other serious complications. Patients with NAION have no benefit of the medication, but can have serious side effects, why it is very important to differentiate between these conditions. In this project, the investigators will use FDG PET/MRI with Black Blood (BB) sequences and OCT-imaging to study patients with GCA and/or ischemic optic nerve disease. The investigators will look for signs of inflammation in and around the small vessels of the orbit using PET/MRI and study subtle retinal changes using OCT images. The investigators want to answer the following research questions: Do patients with ischemic optic nerve disease and GCA show signs of inflammation in the orbital vessel wall on PET/MRI-scans, that are not present in patients with NAION? Do GCA patients without vision loss, but with signs of orbital vessel wall inflammation on PET/MRI-scans, have a higher risk of later vision loss than GCA patients without? Can subtle changes in the retina, detectable through OCT, help distinguish between GCA-related vision loss and NAION? This will, to our knowledge, be the first study to systematically use FDG PET/MRI BB-scans to illuminate vascular changes in the orbit of patients with GCA and/or ischemic optic nerve disease. The results may improve diagnosis and treatment of GCA and NAION in the future. The investigators hope that this will help prevent blindness and other serious complications in patients with GCA, while also avoiding unnecessary treatments for patients with NAION.
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