04/02/2026
Polymyalgia rheumatic (PMR) is a common inflammatory disease in older adults. It is characterized by a sudden onset of shoulder and hip pain, morning stiffness and elevated inflammatory markers in the blood. Steroids, like prednisone, are the first line of treatment and typically result in a rapid resolution of pain. Almost half of patients report relapses after tapering steroids and many remain on them for multiple years. Unfortunately, that means experiencing the myriad of side-effects of steroids, including weight gain, infections, increased blood sugar, and muscle and bone density loss. New medications called biologics are being used to minimize the amount of steroids taken. Sarilumab (Kevzara) is approved for use in PMR and trials of other biologics, including tocilizumab (Actemra) and secukinumab (Cosentyx) have shown promise. Correctly diagnosing PMR is still difficult as there is no specific test for the disease and imaging studies have been mixed, so a recent review suggests that patients should be seen by a specialist to confirm the diagnosis and start on an appropriate treatment regimen.
