Top Tweets for #Rheumatica
A retrospective study that compared immune checkpoint inhibitor (ICI)-induced #polymyalgia #rheumatica (PMR) with idiopathic PMR using 18F-fluorodeoxyglucose (FDG) PET/CT found that the distribution and intensity of musculoskeletal inflammation on 18F-FDG PET/CT differ between them.
๐ฆ๐๐๐ฑ๐ ๐๐ฒ๐๐ถ๐ด๐ป:
โฆ Observational, retrospective, single-center comparative study including 20 patients with ICI-PMR (mostly treated for metastatic melanoma) and 23 patients with idiopathic PMR.
โฆ All patients had an 18F-FDG PET/CT scan performed within 3 months before diagnosis.
โฆ 18F-FDG uptake was semi-quantitatively assessed by two independent readers in 20 musculoskeletal regions of interest.
๐๐ฒ๐ ๐ณ๐ถ๐ป๐ฑ๐ถ๐ป๐ด๐:
โฆ Similar CRP levels, but higher peripheral arthritis in ICI-PMR.
โฆ ICI-PMR showed significantly lower FDG uptake in: ischial tuberosities, greater trochanters, anterior pubic symphysis, iliopectineal bursae, sternoclavicular joints, and interspinous bursae.
โฆ Differences remained significant after adjusting for peripheral arthritis.
โฆ Leuven and Besanรงon scores were significantly lower in ICI-PMR.
In short, while both conditions can look somewhat similar on PET/CT, ICI-related PMR tends to show milder and more limited musculoskeletal uptake compared to classic idiopathic PMR. This may help clinicians distinguish the two entities when evaluating patients on immune checkpoint inhibitors who develop PMR-like symptoms.
*Bouchut A, Jacquet T, Gouyette Y, et al. 18F-fluorodeoxyglucose PET/CT uptake characteristics in ICI-induced polymyalgia rheumatica compared to idiopathic polymyalgia rheumatica. Rheumatology (Oxford). Published online April 6, 2026.
๐ https://t.co/uo5dOhMSkw
In a large retrospective cohort study, the risk of #aortic complications in patients with #polymyalgia #rheumatica (PMR) was lower than that of patients with giant cell #arteritis (GCA); the risk was similar as compared to people in a general population cohort. Importantly, patients with PMR who were later diagnosed with GCA had a similar risk of developing aortic complications from the time point of GCA diagnosis as compared to those who were initially diagnosed with GCA. This information provides important data to guide screening practices for aortic complications in patients with PMR and GCA.
*Carlson K, Kaymakci M, Sattui SE, Putman M. Incidence of aortic aneurysm, dissection, or rupture among patients with polymyalgia rheumatica and giant cell arteritis. Seminars in Arthritis and Rheumatism, 2025.
๐https://t.co/yxkXWPgN51
Although most of the clinical and ultrasonographic findings are comparable in both immune #checkpoint inhibitor-mediated #polymyalgia #rheumatica (ICI-PMR) and primary PMR, laboratory and 18F-FDG-PET/CT assessments suggest that ICI-PMR is associated with less intense #inflammation than primary PMR. Therefore, ICI-PMR can be managed with lower glucocorticoid doses than the primary PMR group, while this treatment could be discontinued more quickly. These findings indicate that ICI-PMR is a PMR-like syndrome rather than a true form of primary PMR.
*Vermeulen OCB, Brouwer E, Slart RHJA, et al. Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement. Rheumatology (Oxford). 2025;64(2):771-779.
๐https://t.co/jtxujYtsAr
Predicting who will develop
โถ๏ธ#GCA
In #Swedish study with
#PMR
โฌ๏ธ in HIGH ESR/CRP
โฌ๏ธfemale
โฌ๏ธ if hip pain/stiffness
Not all sig 1 mo after #prednisone started
Only 9% with #polymyalgia #rheumatica developed #GCA
? โฌ๏ธGCA % in PMR over time
#POS0411 @eular_org @RheumNow
Leflunomide for #PMR?
โ
#Leflunomide FAR more effective than #MTX in #polymyalgia #rheumatica
V fast withdrawal of #prednisone
#LEF ~4 to 5 months
#MTX 30 mos!
โฌ๏ธflares w LEF
๐ฎ
#EULAR2024 @RheumNow @eular_org
@SebaUltraTrail
๐Share a review article
"#Polymyalgia #rheumatica - an up-to-date review on diagnosis and management"
๐https://t.co/FryccbVdMm #vasculitis
Check out our recent publication on suspected #polymyalgia #rheumatica
โถ๏ธ early referral
โถ๏ธ clinical examination
โถ๏ธ role of primary care
โถ๏ธ glucocorticoids
๐ https://t.co/VsLUh31a5I
@cmukhtyar @Sarah_L_Mackie @SattuiSEMD @anisha_dua @cristinadbponte @VictorioPQ @drceowen
Time will tell who to use a steroid sparing drug such as #sarilumab in #PMR #polymyalgia #rheumatica #ClinicalPearl
So proud of the very first NEJM research paper on PMR offering alternative to steroids for relapsing disease! Sarilumab for Relapse of Polymyalgia Rheumatica during Glucocorticoid Taper | NEJM https://t.co/kIVqqtoxbQ
#GreenTea, The Beverage In the Alleviated Symptoms, Reduces Risk and Treatment of Polymyalgia #Rheumatica (PMR) https://t.co/YwpAgBgZbT
@TheLancetRheum What about cost (?in)effectiveness of advanced therapies in #polymyalgia #rheumatica? #Sarilumab- FDA approved, IL17i, #rituximab, #JAKi and more advanced therapy trials. Limiting #prednisone is great but at what cost? #MedEd #MedTwitter #ClinicalPearl. Do #RCTs but who ๐ต?
And so it begins. Moving #IL6i biologics to #polymyalgia #rheumatica. More to come. Great #glucocorticoid sparing BUT what about cost effectiveness? Dunno ๐คท #MedEd #MedTwitter
The #FDA approval was based on positive results from the Phase 3 SAPHYR trial, which showed that nearly 3 times more patients with #PolymyalgiaRheumatica achieved sustained remission with #sarilumab when compared with placebo.
https://t.co/S0NUHKVSWr
Most Common Diseases of Ages of 50 Plus - Musculoskeletal disorders (MSDs) - #PolymalagiaArthritis(#Rheumatica, #PMR) https://t.co/sVbPigJ2x9
#PolymyalgiaArthritis (#Rheumatica): The Risk Factorshttps://kylejnorton.blogspot.com/2016/03/most-common-disease-of-elder-clinical_14.html
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