Entering A New Era of Steroid-Sparing Options for Polymyalgia Rheumatica, With Anisha Dua, MD, MPH

Polymyalgia rheumatica (PMR) is common, frequently managed in primary care, and until recently had almost no therapeutic options beyond corticosteroids. That is beginning to change — and the pace of change is accelerating.

PMR management began its transformation in 2023 with the United States Food and Drug Administration (FDA) approval of IL-6 inhibitor sarilumab, the first and only biologic for the disease, and continues to evolve, with multiple agents now in active trials and the full data set on secukinumab in PMR expected shortly this year.^1,2

To discuss the year's advances in PMR and its vasculitis-adjacent neighbor giant cell arteritis, RheumatologyLive spoke with Anisha Dua, MD, MPH, Professor of Medicine, Rheumatology Fellowship Program Director, and Director of the Northwestern Vasculitis Center at Northwestern University Feinberg School of Medicine in Chicago, following her talks at the 2026 Rheumatology Winter Clinical Symposium, held in Maui, Hawaii, on February 11–14.³ One of Dua's talks focused heavily on PMR given the volume of recent data — and a care delivery gap that makes those advances all the more urgent: because rheumatology access delays are driving substantial PMR management into primary care, many patients are not reaching specialists best positioned to offer newer therapies until they have already become steroid-dependent or clinically complicated. Dua's position is that every PMR patient should be seen by a rheumatologist at least once, with co-management thereafter, and that fast-track clinic models may offer a practical path toward closing that access gap.

On the diagnostic front, Dua highlighted expanding imaging data refining clinicians' ability to differentiate PMR from mimicking conditions and more granularly characterize its relationship to giant cell arteritis — including identification of the subset of PMR patients with evidence of large-vessel inflammation on imaging, a finding with direct management implications.

Therapeutically, sarilumab has now been available for relapsing or refractory PMR since its 2023 approval — based on SAPHYR phase 3 data showing sustained remission at 52 weeks in 28% of sarilumab-treated patients versus 10% on placebo (P = .0193) — and has already shifted the treatment paradigm by establishing the first approved steroid-sparing option for the disease. What has the field's attention now is what comes next: secukinumab, which produced positive results in PMR despite not meeting its endpoint in giant cell arteritis, has final trial data pending, and Dua described its potential approval as an exciting near-term prospect. Beyond that, JAK inhibitor trials and rituximab studies are adding further depth to a pipeline that, by Dua's assessment, puts the field at an inflection point where patients with a disease long undertreated will finally have meaningful choices.

“There's a lot of studies looking at different possible agents. So I think we're in a super exciting time. Things are going to change, and our patients are going to have more options. So I'm excited about that,” Dua said.

References

1. Kevzara® (sarilumab) Approved by FDA as First and Only Biologic Indicated for Patients with Polymyalgia Rheumatica. News release. Regeneron. February 28, 2023. https://investor.regeneron.com/news-releases/news-release-details/kevzarar-sarilumab-approved-fda-first-and-only-biologic/

2. Novartis Cosentyx® meets primary and all secondary endpoints in Phase III trial in patients with polymyalgia rheumatica (PMR). News release. Novartis. October 22, 2025. https://www.novartis.com/news/media-releases/novartis-cosentyx-meets-primary-and-all-secondary-endpoints-phase-iii-trial-patients-polymyalgia-rheumatica-pmr

3. Dua A. Evidence based medicine: Vasculitis adjacent conditions: what’s new? Presented at: RWCS 2026, held February 11-14 in Maui, Hawaii.