The annual American College of Rheumatology (ACR) meeting, now called ACR Convergence, is one of the premier conferences for the presentation of advances in the treatment of rheumatic diseases. Rheumatologists from all around the globe attend the meeting to find out about exciting new knowledge including the results of new therapeutic trials. Polymyalgia rheumatica (PMR) is one of the most common systemic rheumatic diseases affecting older adults. Despite its relatively high prevalence among systemic rheumatic diseases, PMR has usually had a rather “shy presence” in ACR conferences, even more so when it comes to clinical trials.
Following the presentation of the PMR-SPARE and the BRIDGE-PMR trials during ACR Convergence 21, there continues to be an increase in PMR research covering clinical trials, basic and observational research, as well as scientific sessions during this year’s meeting.
On 11/14, during the Plenary III session, results from SAPHYR study will be presented. SAPHYR is a phase 3, multicenter, randomized, double-blind, placebo-controlled trial using sarilumab in patients with glucocorticoid resistant PMR. This large multicentric study compared the use of sarilumab (200 mg every 2 weeks) with a 14-weeks glucocorticoid tapered regimen vs placebo and a 52-week glucocorticoid regimen. The SAPHYR study will represent one the largest trials to date in PMR and will present important data regarding clinical and patient-reported outcomes. Aligned with the observations on the primary outcomes for the trial, significant improvements were also observed in patient-reported outcomes. These results will be presented on 11/14 during the Patient Outcomes, Preferences, and Attitudes: Patient Priorities and Preferences: Interventions and Transformations.
In the same line, the results from the recently published SEMAPHORE trial will be presented on 11/13 during the Miscellaneous Rheumatic and Inflammatory Diseases II session. This large multicenter trial, which included 17 sites in France, showed an improvement with intravenous tocilizumab, compared to placebo, during the 24-week period study. Finally, one small interventional study describing the use of tofacitinib in PMR will also be presented during this session.
With new evidence on the use of steroid-sparing agents, data on outcomes and treatment utilization patterns is needed. Abstracts 1547 and 1546 provide some information on this matter using large registry and claims data. Other abstracts of interest include translational studies looking into immune cell disturbance and neutrophil activation (Abstracts 1548 and 1545, respectively), clinical evaluation of patients with PMR without C-reactive protein (Abstract 1544) and the prevalence of subclinical giant cell arteritis in patients with PMR (Abstract 1619, to be presented in on 11/13 during Vasculitis – Non-ANCA Associated and Related Disorders).
Summarizing all emerging data on PMR, the scientific session Polymyalgia Rheumatica: New Tricks for an Old Disease will cover new advances in the treatment of PMR. This session will be held on 11/14 and besides an overview of the current treatment practices for PMR, it will discuss new imaging modalities in diagnosis and monitoring, as well as treatment in the context of emerging new steroid-sparing agents for the treatment of PMR. This last part of the session will focus on the need to balance between the risks and benefits of further immunosuppression, including how to better identify patients who are candidates for these interventions (e.g., patients at high risk for glucocorticoid refractory disease and/or glucocorticoid toxicity).
The recent surge in clinical trials and epidemiological studies has brought PMR back to the “big stage”. It seems that during ACR Convergence 2022, PMR research will continue to be on the rise, and we can only hope that these new emerging data will address the persistent knowledge gaps in the treatment of patients living with PMR.
Dr. Sattui is supported by the Rheumatology Research Foundation RISE Pilot Award and by the Bristol Myers Squibb Foundation Winn Career Development Award. Dr. Sattui reports research support (clinical trials) from Astra-Zeneca and consulting for Sanofi (not paid).
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