Recognizing Polymyalgia Rheumatica: An Expert’s Guidance to Early Diagnosis, Treatment Options, and Symptom Management

As people age, it's sometimes easy to attribute body aches to daily routines or external factors. However, stiffness and pain in a person's shoulders, neck or hips could signal something more serious, like polymyalgia rheumatica (PMR).

PMR is a type of inflammatory rheumatic disease that impacts around 1 in 2,000 people aged 50 and above, with women more likely to be affected, and the risk of developing it increases with age.^1-2 Many people with PMR report worsening symptoms in the morning or after periods of inactivity, particularly when performing everyday tasks like lifting objects or standing up. Recognizing the early signs of PMR and talking to a doctor are important to figuring out a treatment plan to help manage symptoms.

Dr. Grace Wright, MD, PhD, president of the Association of Women in Rheumatology and a practicing rheumatologist in New York City, explains how doctors can guide their patients through their diagnosis and treatment experience. She explains that by encouraging open communication between patients and doctors, "patients can feel empowered and informed throughout their care journey."

Consult Your Doctor Early: Addressing PMR Symptoms for Timely Diagnosis and Treatment

• Patients should consider talking to their doctor about potential PMR symptoms such as muscle and joint pain as soon as they notice any significant changes in their day-to-day life. Dr. Wright urges patients to openly describe how they're feeling like, "I can't get up from a chair," or "I'm having difficulty putting away objects over my head." If there is a sudden onset of symptoms, it is important to seek medical attention immediately. Even with a more gradual onset of PMR, when aches and stiffness slowly develop over time, patients should still consult with their doctor early.

Effective Communication: Differentiating PMR Symptoms for Accurate Diagnosis

• Listening closely to patients' concerns and understanding their full experience can help doctors accurately differentiate PMR symptoms from other conditions. For example, understanding extreme fatigue compared to general malaise can help distinguish PMR from another common inflammatory disease, like arthritis. Dr. Wright encourages patients to focus on the functional changes in their routine when describing symptoms. On top of saying "my muscles feel weak," they can also be more descriptive by saying, "I can no longer drink out of a coffee mug. I have to use a plastic cup instead." These types of details can help give doctors clear systemic signs of PMR, demonstrating pain and inflammation, which are important symptom identifiers for a diagnosis.

Managing PMR: Understanding Treatment Options and the Importance of Monitoring Health Conditions

• In the patients that Dr. Wright has treated, she states that there are ways people can manage their condition, beginning with treatments such as corticosteroids to help reduce inflammation and alleviate pain. However, given patients can initially be prescribed a high dose of corticosteroids, Dr. Wright says physicians should, "closely monitor side effects like high blood pressure and elevated blood sugar." She says, "For patients who live with health conditions like diabetes or heart disease, it's important that they inform their doctor, as taking steroids—which can work quickly to provide PMR symptom relief and is tapered off to avoid flares—can potentially also worsen existing health conditions." Healthy lifestyle changes may also help people living with PMR manage their symptoms. "Incorporating gentle exercise or physical therapy can help maintain muscle tone and mass," says Dr. Wright. Sometimes PMR symptoms may improve with the help of steroids, but if a patient is not finding relief in their current treatment plan, they should talk with their doctor about other options.

Resources and Support to Stay Informed

• A PMR diagnosis can be challenging and can make one feel alone. It's important that people living with PMR tell their family, friends and loved ones how they are feeling and also not be afraid to ask for help. Dr. Wright encourages her patients to stay informed and be proactive about managing their condition. There are organizations to help connect patients with one another and provide educational resources like CreakyJoints (part of the Global Health Living Foundation) and also the Arthritis Foundation. PMRandYou is another online resource where patients can get additional information.

Another Option for Treating PMR

• KEVZARA^® (sarilumab), an injectable prescription medicine called an interleukin-6 (IL-6) receptor blocker, is used to treat adult patients with PMR after corticosteroids have been used and did not work well or when a slow decrease in the dose of corticosteroids (taper) cannot be tolerated. Il-6 is an immune system protein, which can cause the immune system to attack healthy cells if there is too much of it in the body. High levels of IL-6 are believed to play an important role in PMR symptoms. To learn about KEVZARA, practical tips for living with PMR, and to determine if this treatment is suitable for you, visit www.kevzara.com/pmr.

Important Safety Information

KEVZARA^® (sarilumab) can cause serious side effects including:

• SERIOUS INFECTIONS: KEVZARA is a medicine that affects your immune system. KEVZARA can lower the ability of your immune system to fight infections. Some people have had serious infections while using KEVZARA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should test you for TB before starting KEVZARA. Your healthcare provider should monitor you closely for signs and symptoms of TB during treatment with KEVZARA.
• Before starting KEVZARA, tell your healthcare provider if you
  • think you have an infection or have signs or symptoms of an infection, with or without a fever such as sweats or chills, muscle aches, a cough, shortness of breath, blood in your phlegm, weight loss, warm, red, or painful skin or sores on your body, diarrhea or stomach pain, burning when you urinate or urinating more often than normal, if you feel very tired, or if you are being treated for an infection, get a lot of infections or have repeated infections.
  • have diabetes, HIV, or a weakened immune system.
  • have TB, or have been in close contact with someone with TB.
  • live or have lived, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance of getting certain fungal infections (histoplasmosis, coccidioidomycosis, or blastomycosis).
  • have or have had hepatitis.
• After starting KEVZARA, call your healthcare provider right away if you have any symptoms of an infection.
• CHANGES IN CERTAIN LABORATORY TEST RESULTS: Your healthcare provider should do blood tests before and after starting KEVZARA to check for low neutrophil (white blood cells that help the body fight off bacterial infections) counts, low platelet (blood cells that help with blood clotting and stop bleeding) counts, and an increase in certain liver function tests. Changes in test results are common with KEVZARA and can be severe. You may also have changes in other laboratory tests, such as your blood cholesterol levels. Your healthcare provider should do blood tests 4 to 8 weeks after starting KEVZARA and then every 6 months during treatment to check for an increase in blood cholesterol levels.
• TEARS (PERFORATION) OF THE STOMACH OR INTESTINES: Tell your healthcare provider if you have had a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines. Some people using KEVZARA get tears in their stomach or intestines. Some people using KEVZARA get tears in their stomach or intestine. This happens most often in people who also take nonsteroidal anti-inflammatorydrugs (NSAIDS), corticosteroids, or methotrexate. Call your healthcare provider right away if you have fever and stomach (abdominal) pain that does not go away.
• CANCER: KEVZARA may increase your risk of certain cancers by changing the way your immune system works. Tell your healthcare provider if you have ever had any type of cancer.
• SERIOUS ALLERGIC REACTIONS: Serious allergic reactions can happen with KEVZARA. Get medical attention right away if you have any of the following signs: shortness of breath or trouble breathing; feeling dizzy or faint; swelling of your lips, tongue, or face; moderate or severe stomach (abdominal) pain or vomiting; or chest pain.
• Do not use KEVZARA if you are allergic to sarilumab or any of the ingredients of KEVZARA.
• Before using KEVZARA, tell your healthcare provider if you
  • have an infection.
  • have liver problems.
  • have had stomach (abdominal) pain or a condition known as diverticulitis (inflammation in parts of the large intestine) or ulcers in your stomach or intestines.
  • recently received or are scheduled to receive a vaccine. People who take KEVZARA should not receive live vaccines.
    • All vaccines should be brought up-to-date before starting KEVZARA, unless urgent treatment initiation is required.
  • plan to have surgery or a medical procedure.
  • are pregnant or plan to become pregnant. It is not known if KEVZARA will harm your unborn baby.
  • are breastfeeding or plan to breastfeed. Talk to your healthcare provider about the best way to feed your baby if you use KEVZARA. It is not known if KEVZARA passes into your breast milk.
  • take prescription or nonprescription medicines, vitamins, or herbal supplements. It is especially important to tell your healthcare provider if you use:
    • any other medicines to treat your RA or PMR. Using KEVZARA with these medicines may increase your risk of infection.
    • medicines that affect the way certain liver enzymes work. Ask your healthcare provider if you are not sure if your medicine is one of these.

• The most common side effects include:
  • injection site redness
  • injection site itching
  • upper respiratory tract infection
  • urinary tract infection
  • nasal congestion, sore throat, and runny nose

These are not all the possible side effects of KEVZARA. Tell your doctor about any side effect that bothers you or does not go away. You are encouraged to report side effects of prescription drugs to the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.

To learn more, talk about KEVZARA with your healthcare provider or pharmacist. The FDA-approved Medication Guide and Prescribing Information can be found at www.KEVZARA.com or by calling 1-844- KEVZARA.

Please click here to see full Prescribing Information including risk of SERIOUS SIDE EFFECTS and Medication Guide.

References

1. The Lancet. "Polymyalgia rheumatica." Available at: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01310-7/abstract
2. National Library of Medicine. "An update on polymyalgia rheumatica." Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9796644/

MAT-US-2410843-v1.0-11/2024