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Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are inflammatory disorders of the vasculature.

  • PMR affects the limbs, causing pain, stiffness and motion limitation. PMR prevalence is 0.5-0.7% among adults 50 or older.

  • GCA affects head vessels, causing severe headaches and jaw pain. GCA can lead to blindness, stroke or aneurysm. GCA prevalence is about 0.2% among adults 50 or older.

  • The diseases occur together: about 15% of PMR patients have GCA, and about 50% of GCA patients have PMR.

  • Both diseases occur more frequently in women.  

 

Here's why a safer oral corticosteroid is needed for PMR and GCA.

  • Together, they are the #1 reason for long-term oral corticosteroid prescription. Patients are generally prescribed oral corticosteroids for a year or longer.

  • CS are the only FDA-approved drugs for PMR. Tocilizumab is indicated to treat GCA in combination with CS. Methotrexate is used off-label, most often together with a corticosteroid.

  • There is a very limited pipeline of biologics to treat GCA currently in Phase 2 or Phase 3 clinical trials.

  • Typical patients are older women, who are at increased risk for fractures and other corticosteroid side effects.

 

Additional promising indications for a safer oral corticosteroid include asthma/chronic obstructive pulmonary disease (#1 reason for oral corticosteroid prescription), rheumatoid arthritis, and lymphomas and leukemias. Patients with an elevated corticosteroid side effect risk include the elderly and those with diabetes.