Treatment of Polymyalgia Rheumatica by Rheumatology Providers: Analysis from the ACR Rheumatology Informatics System for Effectiveness registry

Objective To describe the demographics, comorbidities, and treatment patterns in a national cohort of patients with polymyalgia rheumatica (PMR) receiving care from rheumatology providers. Methods Patients with PMR were identified in the ACR Rheumatology Informatics System for Effectiveness (RISE) registry from 2016‐2022. Use of glucocorticoids and immunomodulatory antirheumatic medications used as steroid‐sparing agents were examined overall, and in a subgroup of patients new to rheumatology practices, the majority with presumed new‐onset PMR. In these new patients, multivariate logistic regressions were performed to identify factors associated with persistent glucocorticoid and steroid‐sparing agent use at 12‐24 months. Results A total of 26,102 patients with PMR were identified, of which 16,703 new patients were included in the main analysis. Patients were predominantly female (55.8%), white (46.7%), with a mean age of 72.0 years. Hypertension (81.2%), congestive heart failure (52.4%), hyperlipidemia (41.3%) and ischemic heart disease (36.0%) were the most prevalent comorbidities. At baseline, 92.3% of patients were on glucocorticoids and only 13.1% where on a steroid‐sparing agent. At 12‐24 months, most patients remained on glucocorticoids (63.8%). Although there was an increase in use through follow‐up, anti‐rheumatic medications were prescribed only to a minority (39.0%) of patients with PMR. Conclusion In this large US‐based study of patients with PMR receiving rheumatology care, only a minority of patients were prescribed steroid‐sparing agents during the first 24 months of follow‐up; most patients remained on glucocorticoids past 1 year. Further identification of patients who would benefit of steroid‐sparing agents and timing of steroid‐sparing agent initiation is needed. image