Autoimmunity reviewsAug 9, 2024

Immunomodulatory treatments being tested for polymyalgia rheumatica and giant cell arteritis: A review of clinical trials

Longevity & Aging Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 2, 2026

Abstract

A total of 23 disease-modifying anti-rheumatic drugs (DMARDs) were identified for polymyalgia rheumatica (PMR) and giant cell arteritis (GCA).

For PMR, 15 DMARDs were identified, including 2 conventional synthetic, 11 biologic, and 2 targeted synthetic options.
For GCA, 18 DMARDs were identified, comprising 2 conventional synthetic, 14 biologic, and 2 targeted synthetic options.
Currently, only 2 approved corticosteroid-sparing therapies are available, both targeting the IL-6 signaling pathway.
Tocilizumab is approved for GCA, while sarilumab is approved for PMR.
Most development efforts for new treatments seem to focus on repurposing existing drugs rather than developing new therapies.

Simplified

INTRODUCTION: The objective of this systematic review was to provide an overview of current developments and potentially available therapeutic options for polymyalgia rheumatic (PMR) and giant cell arteritis (GCA), in the coming years.

METHODS: We conducted a systematic review of 17 national and international clinical trial databases for all disease-modifying anti-rheumatic drugs (DMARDs) for PMR and GCA that are already marketed, in clinical development or withdrawn. The search was performed on January 2024, with the keywords "polymyalgia rheumatica" and "giant cell arteritis". For each molecule, we only considered the study at the most advanced stage of clinical development.

RESULTS: For PMR, a total of 15 DMARDs were identified: 2 conventional synthetic DMARDs (csDMARDs), 11 biologic DMARDs (bDMARDs) and 2 targeted synthetic DMARDs (tsDMARDs). For GCA, 18 DMARDs were identified: 2 csDMARDs, 14 bDMARDs and 2 tsDMARDs. Currently, there are only 2 approved corticosteroid-sparing therapies in these diseases, which both target the IL-6 signaling pathway, namely tocilizumab in GCA and sarilumab in PMR. Most of the molecules in current development are repurposed from from other conditions and clinical research in PMR/GCA seems to be mostly driven by the potential to repurpose existing treatments rather than by translational research.

CONCLUSION: This systematic review identified 23 DMARDs evaluated for PMR and GCA: 3 csDMARDs, 17 bDMARDs and 3 tsDMARDs. Several promising treatments are likely to be marketed in the coming years.

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Immunomodulatory treatments being tested for polymyalgia rheumatica and giant cell arteritis: A review of clinical trials

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