Vasculitis & polymyalgia rheumatica
Effectiveness and safety of interleukin 6 receptor inhibitors versus conventional immunomodulatory therapy in steroid-refractory polymyalgia rheumatica
Main finding · GC discontinuationResult — go to the resultAdjusted hazard ratio 1.28 95% CI 1.02–1.60Authors' conclusion
IL-6Ri therapy was more effective as a steroid-sparing agent than csIM for PMR with no new safety findings.
Study context
- Population
- Patients with PMR on glucocorticoids (GC), without prior IL-6Ri exposure, initiating IL-6Ri/conventional synthetic immunomodulators (csIM) therapy; US Medicare fee-for-service claims; csIM-naïve and csIM-experienced cohorts415 matched pairs (187/228)
- Exposure
- IL-6R inhibitors vs conventional synthetic immunomodulators in PMR on GC
- Outcome
- Time-to-GC discontinuation and time-to-minimal GC use (≤2 mg/day or stop GC)
- Follow-up
- Year 1
Methodological detailscomparative cohort, matched using direct methods and propensity score methods, US Medicare claims data
- Comparative cohort
- Matched using direct methods and propensity score methods
- US Medicare claims data
Main finding
GC discontinuation
Adjusted hazard ratio
1.28
95% CI 1.02–1.60
P = 0.031
IL-6Rivs csIM
aHR 1.28 (95% CI 1.02–1.60); P = 0.031
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| Co-primary: minimal GC use (≤2 mg/day or stop GC) · year 1 | 1.28 (1.03–1.58) | P = 0.025 | |
| 0.512Adjusted hazard ratio (log scale) |
Safety
Primary hospitalised infections, IR/100 patient-years · year 1
Primary hospitalised infections, IR/100 patient-years · year 2
Primary hospitalised infections, IR/100 patient-years · year 2
- Similar for year 2
Other adverse events of special interest
- Incidence rates (IRs) low and comparable in both groups
Original publication
Effectiveness and safety of interleukin 6 receptor inhibitors versus conventional immunomodulatory therapy in steroid-refractory polymyalgia rheumatica. RMD Open. Published 3 August 2026. doi:10.
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