VIDEO: Recent clinical trial results, ongoing research in polymyalgia rheumatica

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So it's an exciting time again to talk about research in PMR because a lot of it is happening for what is one of our more common diseases, however, neglected. First exciting thing, of course, is trials. So as I mentioned, we had a Phase-III sarilumab trial, got published in the, New England Journal of Medicine last year. FDA approved the use of sarilumab in refractory and relapse in disease. But we have other agents as well, including IL-17 Inhibitors, JAK inhibitors that are currently with ongoing trials. There's the leflunomide trials I mentioned as well. So there's finally discussion and emerging options for therapeutic PMR patients. That's, I think, on the trial perspective, what is certainly exciting.

What is also coming recently is, and it's remains a huge unmet need as well for PMR and certainly for GCA, is understanding the pathophysiology of both of these conditions better. I like the fact to see a lot of more work, specifically focused on PMR, because I think a lot of it has happened under the GCA umbrella, and specific focus on PMR is important for us to understand because there's still some potential differences between both conditions. And this allows us to better understand and guide the treatment of those patients. Another exciting area in the field of PMR is all the emerging imaging studies. And that is great because, as I said in my first question, there's still challenges to the diagnosis of PMR. Use of ultrasound, which has continued to expand, I think rightfully, we know that the use of ultrasound actually improves sensitivity and specificity of the 2012 classification criteria. And those are provisional criteria.

But the studies that have been done on MRI imaging and PET imaging have actually allowed us not only to think and potentially kind of, there's proposals for different algorithms to better diagnose the disease, but certainly, also better understand the disease. And I think it's allowing us to better understand the different features of the disease and expand at this point, I think, a little bit of archaic concept of shoulder and hip pain, which I think it's fascinating besides, of course, very eye engaging given very nice PET imaging. But there's still a lot of things that we need to better. So I'm going to spin this question a little more to what we still need to understand, which is, as I said, kind of what are the trajectories, how the subgroups of patients for us to better understand and predict what the outcomes of our patients going to be.

Second, and this is something I'm biased on, but I think it's association with aging. There's been some new studies, regarding immunosenescence in this patients as well, which I think it's fascinating. There's been a lot of work with disorder neuritis, but seen it and PMR, I think it's also exciting and I have specifically the interest around frailty as well, which I've seen with some upcoming studies as well on this because frailty as much as said, several other geriatric symptoms and another layer of complexity for the treatment of older adults with PMR. So I think that's an exciting growing part of the field. And again, I'm saying this with a bias that's part of my in research interest. And I think there's also a need to better understand some other non-pharmacologic interventions, such as physical activity, which makes absolute sense in older adults who are having pain, limited mobility, and where physical activity would play a significant role.

But on top of all this exciting research, the one important aspect of it as well is a kind of better research and tool implementation of care pathways in the care of these patients. Because as I mentioned, although this is with variability among different countries, a lot of these patients are taken care of in the primary care setting. And there is a need to better understand the ways in which we can actually collaborate and work with and non-specialists to provide earlier assessment for this patient and early assessment for patients at risk for worse outcomes. There's some going experience from fast track pathways for the assessment of PMR, and I think nowadays even more so with use of telemedicine, econs and so forth. I hope this work continues to grow.