{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:51:20Z","timestamp":1785761480182,"version":"3.56.0"},"reference-count":41,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"unspecified","delay-in-days":33,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009857","name":"Regeneron Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009857","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Foundation for Advancing Science, Technology, Education and Research (FASTER), Birmingham, AL, USA"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,6,17]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effectiveness and safety of interleukin 6 receptor inhibitors (IL-6Ris) and conventional synthetic immunomodulators (csIM) in patients with polymyalgia rheumatica (PMR) who received glucocorticoids (GC) and initiated a new therapy for PMR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated the effectiveness and safety of IL-6Ris in a retrospective comparative cohort created from the US Medicare fee-for-service medical and part D prescription claims data. Patients with PMR, on GC, without prior IL-6Ri exposure and initiating IL-6Ri\/csIM therapy were identified. These patients were categorised into csIM-na\u00efve and csIM-experienced cohorts and matched using direct methods and propensity score methods. Primary endpoints were time-to-GC discontinuation and time-to-minimal GC use (\u22642\u2009mg\/day or stop GC) through year 1. Incidence rates (IRs) for adverse events of special interest were reported for IL-6Ri and csIM initiators through year 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 415 matched treatment pairs (187\/228, csIM-na\u00efve\/csIM-experienced). IL-6Ri initiators were more likely to discontinue GC (adjusted HR (aHR) 1.28, 95% CI 1.02 to 1.60; p=0.031) or achieve minimal GC use (aHR 1.28, 95% CI 1.03 to 1.58; p=0.025) by year 1 versus csIM initiators. At year 1, IR (95%\u2009CI)\/100 patient-years for primary hospitalised infections was higher for IL-6Ri initiators versus csIM initiators (12.2 (95% CI 8.9 to 16.3)\u2009vs 5.7 (95% CI 3.6 to 8.6)); however, it was similar for year 2 (5.8 (95% CI 3.3 to 9.6)\u2009vs 6.4 (95% CI 3.8 to 10.1)). For other events of interest, the IRs were low and comparable in both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IL-6Ri therapy was more effective as a steroid-sparing agent than csIM for PMR with no new safety findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2026-006850","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:15:21Z","timestamp":1785759321000},"page":"e006850","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and safety of interleukin 6 receptor inhibitors versus conventional immunomodulatory therapy in steroid-refractory polymyalgia rheumatica"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3508-9290","authenticated-orcid":false,"given":"Anisha Bharadwaj","family":"Dua","sequence":"first","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F","family":"Spiera","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hospital for Special Surgery, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ara","family":"Dikranian","sequence":"additional","affiliation":[{"name":"Cabrillo Center for Rheumatic Disease, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8773-7739","authenticated-orcid":false,"given":"Cassandra","family":"Calabrese","sequence":"additional","affiliation":[{"name":"Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifton O","family":"Bingham","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerri","family":"Ford","sequence":"additional","affiliation":[{"name":"Sanofi, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Fiore","sequence":"additional","affiliation":[{"name":"Sanofi, Morristown, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lita","family":"Araujo","sequence":"additional","affiliation":[{"name":"Sanofi, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Petruski-Ivleva","sequence":"additional","affiliation":[{"name":"Sanofi, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle L","family":"Isaman","sequence":"additional","affiliation":[{"name":"Sanofi, Cambridge, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenglong","family":"Xie","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, Alabama, USA"},{"name":"Foundation for Advancing Science, Technology, Education and Research, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8907-8976","authenticated-orcid":false,"given":"Jeffrey R","family":"Curtis","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, Alabama, USA"},{"name":"Foundation for Advancing Science, Technology, Education and Research, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"2026080305151519000_12.3.e006850.1","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1016\/S0140-6736(17)31825-1","article-title":"Polymyalgia rheumatica","volume":"390","author":"Gonz\u00e1lez-Gay","year":"2017","journal-title":"The Lancet"},{"key":"2026080305151519000_12.3.e006850.2","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1002\/acr.23132","article-title":"Epidemiology of polymyalgia rheumatica 2000\u20132014 and examination of incidence and survival trends over 45 years: a population-based study","volume":"69","author":"Raheel","year":"2017","journal-title":"Arthritis Care & 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