Among patients with systemic lupus erythematosus (SLE), high titers of anti-phospholipid (aPL) antibodies were most prevalent in whites and Latinos and less so for Black and Asian individuals, researchers found.

JAK inhibitors obviously have dominated a lot of the discussion in our therapeutic landscape over the last couple of years. What about their use in polymyalgia rheumatica? Let's consider.

A TNR Panel discussion on controversies in PMR: diagnosis, imaging, PCP roles, Lumping vs. Splitting. Featuring Drs. Sarah Mackie, Wolfgang Schmidt, and Len Calabrese. Moderated by Dr. David Liew. Recorded on 10/24/2023

Narratives around polymyalgia rheumatica (PMR) often centre around “older people” or even “elderly”. And, indeed, the peak of the age distribution is in the mid-70s – not that everyone that age considers themselves old. Treating “young PMR” can be a very different proposition to treating someone in their seventies or eighties. It’s worth taking time to think this through.

The ACR has published its updated recommendations for prevention and treatment of glucocorticoid-induced osteoporosis (GIOP) for patients receiving >3 months treatment with glucocorticoids (GCs) ≥2.5 mg daily. Despite increasing treatment options to prevent and treat GIOP, many GC-treated patients are not evaluated or treated.

As the sole effective treatment for polymyalgia rheumatica since their development in the 1950’s until recently, the impact of glucocorticoids and PMR outcomes are undeniably intertwined. So much so that when the OMERACT PMR working group first set out to develop a PMR core outcome set, they quickly realised that many of the outcomes important to patients were related to their glucocorticoid use.

When we are considering a diagnosis of PMR, it is key to evaluate the patient accurately and efficiently. Can we use a synchronous audiovisual visit or a rheumatology eConsult to evaluate the patient's symptoms quickly? Does it allow us to make an accurate diagnosis? I would argue that for most of these cases we indeed can. 

For decades we've been screening GCA with a patient history and exam. Doing so with imaging would be a sharp departure from the current standard of care. And you may be asking yourself, well, yeah, but what could it hurt? Don't you want to catch GCA early?  Let me tell you the problems with this. 

PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives. 

Dr. Jack Cush discusses the news, journal articles and regulatory actions. This week we discuss JAKne, DLE and SLE and more.