Background/Purpose: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are systemic inflammatory conditions that predominantly affect individuals ≥50 years of age. The conditions share overlapping clinical features1,2 and can significantly impact patients’ quality of life. The main symptoms of PMR include pain and stiffness in the shoulder, neck, and hips; and patients with GCA present with headache, scalp tenderness, jaw claudication, and visual disturbances2. Both conditions are associated with significant disease burden, including cardiovascular, cerebrovascular diseases, and particularly malignancies for PMR, and a detrimental effect on vision for GCA. The primary treatment is with glucocorticoids (GC); however, unmet needs exist in GC treatments, including non-response to GC, and high relapse rate3. Managing the side effects of long-term GC use is also challenging, with a substantial proportion of patients experiencing disease recurrence during GC dose tapering4. Concerns about long-term use of GC include risk of infections, osteoporosis, cardiovascular events, and metabolic conditions1,2. This multi-country study aims to gain insight into the proportion of patients with PMR and GCA treated with GC and the prevalence of comorbidities across three continents.

Methods: Patients with a first diagnosis (index date) of PMR or GCA aged ≥50 years during 2014-2024 and with at least 1 year of database enrollment pre-index were identified from healthcare databases including PharMetrics Plus (United States), Longitudinal Patient Database (France), and Japan Claims Plus 2. To increase the specificity of the diagnosis, at least two diagnosis codes recorded ≥7 days apart were required. The total number of patients and the distribution by age, sex, and comorbidities during the 12 months before index date were reported. The percentage of patients with at least two GC records within six months after index date was also reported.

Results: Overall 95,768 patients with PMR and 4,826 with GCA were included (Table 1). The mean age ranged from 72.5-78.5 years for PMR and 73.8-77.1 for GCA, and 58.2-62.8% of patients with PMR and 62.4-71.3% with GCA were female. The most common pre-index comorbidity was hypertension in France (PMR: 22.9%, GCA: 30.4%) and the US (PMR: 66.1%, GCA: 69.4%), and cancer in Japan (PMR: 27.3%, GCA: 40.7%) (Figure 1). Between 49.7-71.4% of patients with PMR and 49.4-70.6% with GCA received GC within six months after the first diagnosis.

Conclusion: Across three continents, both patients with PMR and GCA were predominantly of elderly age, with a majority being female, and exhibited a high prevalence of comorbidities. The use of GC was widespread, ranging from 49% of patients in the US to 71% in Japan. The significant burden of common comorbidities, which include diabetes, hypertension, and osteoporosis, underscores the challenges in clinical management of these two conditions. It is crucial to understand how GC are tapered in the real-life settings and to assess the associated safety burden, particularly given the comorbidity profile of these patients.References:1. Gazitt et al. 2020 Curr Rheumatol Rep2. Mahr et al. 2021 Front Med. 3. Unizony et al. 2021 Ann Rheum Dis4. Mainbourg et al. 2020 Arthritis Care Res

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/glucocorticoid-exposure-and-comorbidity-profile-in-patients-with-polymyalgia-rheumatica-and-giant-cell-arteritis-a-multi-country-cohort-study/