Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement

Olof C B Vermeulen; Elisabeth Brouwer; Riemer H J A Slart; Maria Sandovici; Abraham Rutgers; T Jeroen Hilterman; Birgitta Hiddinga; Sjoukje F Oosting; Mathilde Jalving; Albert H de Heij; Daan G Knapen; Geke A P Hospers; Kornelis S M van der Geest

doi:10.1093/rheumatology/keae099

Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement

Olof C B Vermeulen, Elisabeth Brouwer, Riemer H J A Slart, Maria Sandovici, Abraham Rutgers, T Jeroen Hilterman, Birgitta Hiddinga, Sjoukje F Oosting, Mathilde Jalving, Albert H de Heij, Daan G Knapen, Geke A P Hospers, Kornelis S M van der Geest

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Abstract

OBJECTIVES: To compare clinical characteristics, imaging findings and treatment requirements of patients with immune checkpoint inhibitor-mediated polymyalgia rheumatica (ICI-PMR) and primary PMR.

METHODS: This single centre, retrospective cohort study compared ICI-PMR in patients with cancer (n = 15) to patients with primary PMR (n = 37). A comparison was made between clinical symptoms, laboratory markers, ultrasonography,18F-FDG-PET/CT findings and treatment requirements related to PMR.

RESULTS: Patients with ICI-PMR less frequently fulfilled the EULAR/ACR classification criteria for PMR (66.7%) than patients with primary PMR (97.3%). Morning stiffness, weight loss and elevation of the ESR were less frequently seen in patients with ICI-PMR. No differences were observed regarding the presence of inflammatory lesions on ultrasound of the shoulders and hips between the two groups. The Leuven and the Leuven/Groningen 18F-FDG-PET/CT scores were significantly lower in the ICI-PMR group. Finally, the ICI-PMR group could be managed with less glucocorticoids than the primary PMR group.

CONCLUSION: Our findings indicate that ICI-PMR may have a milder course with less inflammation than primary PMR on 18F-FDG-PET/CT. ICI-mediated PMR patients can be managed with a relatively low glucocorticoid dose. Our study underscores that ICI-PMR should be regarded as PMR-like syndrome.

Original language	English
Pages (from-to)	771-779
Number of pages	9
Journal	Rheumatology (Oxford, England)
Volume	64
Issue number	2
DOIs	https://doi.org/10.1093/rheumatology/keae099
Publication status	Published - Feb-2025

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Comment on: Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement. Reply
van der Geest, K. S. M., Sandovici, M., Rutgers, A. & Brouwer, E., Feb-2025, In: Rheumatology (Oxford, England). 64, 2, p. 902-903 2 p.
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Vermeulen, O. C. B., Brouwer, E., Slart, R. H. J. A., Sandovici, M., Rutgers, A., Hilterman, T. J., Hiddinga, B., Oosting, S. F., Jalving, M., de Heij, A. H., Knapen, D. G., Hospers, G. A. P., & van der Geest, K. S. M. (2025). Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement. Rheumatology (Oxford, England), 64(2), 771-779. https://doi.org/10.1093/rheumatology/keae099

@article{01aa707805b2426fb056e672a8fd3f36,

title = "Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement",

abstract = "OBJECTIVES: To compare clinical characteristics, imaging findings and treatment requirements of patients with immune checkpoint inhibitor-mediated polymyalgia rheumatica (ICI-PMR) and primary PMR.METHODS: This single centre, retrospective cohort study compared ICI-PMR in patients with cancer (n = 15) to patients with primary PMR (n = 37). A comparison was made between clinical symptoms, laboratory markers, ultrasonography,18F-FDG-PET/CT findings and treatment requirements related to PMR.RESULTS: Patients with ICI-PMR less frequently fulfilled the EULAR/ACR classification criteria for PMR (66.7%) than patients with primary PMR (97.3%). Morning stiffness, weight loss and elevation of the ESR were less frequently seen in patients with ICI-PMR. No differences were observed regarding the presence of inflammatory lesions on ultrasound of the shoulders and hips between the two groups. The Leuven and the Leuven/Groningen 18F-FDG-PET/CT scores were significantly lower in the ICI-PMR group. Finally, the ICI-PMR group could be managed with less glucocorticoids than the primary PMR group.CONCLUSION: Our findings indicate that ICI-PMR may have a milder course with less inflammation than primary PMR on 18F-FDG-PET/CT. ICI-mediated PMR patients can be managed with a relatively low glucocorticoid dose. Our study underscores that ICI-PMR should be regarded as PMR-like syndrome.",

author = "Vermeulen, {Olof C B} and Elisabeth Brouwer and Slart, {Riemer H J A} and Maria Sandovici and Abraham Rutgers and Hilterman, {T Jeroen} and Birgitta Hiddinga and Oosting, {Sjoukje F} and Mathilde Jalving and {de Heij}, {Albert H} and Knapen, {Daan G} and Hospers, {Geke A P} and {van der Geest}, {Kornelis S M}",

note = "{\textcopyright} The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology.",

year = "2025",

month = feb,

doi = "10.1093/rheumatology/keae099",

language = "English",

volume = "64",

pages = "771--779",

journal = "Rheumatology (Oxford, England)",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "2",

}

Vermeulen, OCB , Brouwer, E , Slart, RHJA , Sandovici, M , Rutgers, A , Hilterman, TJ , Hiddinga, B , Oosting, SF , Jalving, M , de Heij, AH , Knapen, DG , Hospers, GAP & van der Geest, KSM 2025, 'Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement', Rheumatology (Oxford, England), vol. 64, no. 2, pp. 771-779. https://doi.org/10.1093/rheumatology/keae099

TY - JOUR

T1 - Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica

T2 - comparison of disease characteristics and treatment requirement

AU - Vermeulen, Olof C B

AU - Brouwer, Elisabeth

AU - Slart, Riemer H J A

AU - Sandovici, Maria

AU - Rutgers, Abraham

AU - Hilterman, T Jeroen

AU - Hiddinga, Birgitta

AU - Oosting, Sjoukje F

AU - Jalving, Mathilde

AU - de Heij, Albert H

AU - Knapen, Daan G

AU - Hospers, Geke A P

AU - van der Geest, Kornelis S M

PY - 2025/2

Y1 - 2025/2

N2 - OBJECTIVES: To compare clinical characteristics, imaging findings and treatment requirements of patients with immune checkpoint inhibitor-mediated polymyalgia rheumatica (ICI-PMR) and primary PMR.METHODS: This single centre, retrospective cohort study compared ICI-PMR in patients with cancer (n = 15) to patients with primary PMR (n = 37). A comparison was made between clinical symptoms, laboratory markers, ultrasonography,18F-FDG-PET/CT findings and treatment requirements related to PMR.RESULTS: Patients with ICI-PMR less frequently fulfilled the EULAR/ACR classification criteria for PMR (66.7%) than patients with primary PMR (97.3%). Morning stiffness, weight loss and elevation of the ESR were less frequently seen in patients with ICI-PMR. No differences were observed regarding the presence of inflammatory lesions on ultrasound of the shoulders and hips between the two groups. The Leuven and the Leuven/Groningen 18F-FDG-PET/CT scores were significantly lower in the ICI-PMR group. Finally, the ICI-PMR group could be managed with less glucocorticoids than the primary PMR group.CONCLUSION: Our findings indicate that ICI-PMR may have a milder course with less inflammation than primary PMR on 18F-FDG-PET/CT. ICI-mediated PMR patients can be managed with a relatively low glucocorticoid dose. Our study underscores that ICI-PMR should be regarded as PMR-like syndrome.

AB - OBJECTIVES: To compare clinical characteristics, imaging findings and treatment requirements of patients with immune checkpoint inhibitor-mediated polymyalgia rheumatica (ICI-PMR) and primary PMR.METHODS: This single centre, retrospective cohort study compared ICI-PMR in patients with cancer (n = 15) to patients with primary PMR (n = 37). A comparison was made between clinical symptoms, laboratory markers, ultrasonography,18F-FDG-PET/CT findings and treatment requirements related to PMR.RESULTS: Patients with ICI-PMR less frequently fulfilled the EULAR/ACR classification criteria for PMR (66.7%) than patients with primary PMR (97.3%). Morning stiffness, weight loss and elevation of the ESR were less frequently seen in patients with ICI-PMR. No differences were observed regarding the presence of inflammatory lesions on ultrasound of the shoulders and hips between the two groups. The Leuven and the Leuven/Groningen 18F-FDG-PET/CT scores were significantly lower in the ICI-PMR group. Finally, the ICI-PMR group could be managed with less glucocorticoids than the primary PMR group.CONCLUSION: Our findings indicate that ICI-PMR may have a milder course with less inflammation than primary PMR on 18F-FDG-PET/CT. ICI-mediated PMR patients can be managed with a relatively low glucocorticoid dose. Our study underscores that ICI-PMR should be regarded as PMR-like syndrome.

U2 - 10.1093/rheumatology/keae099

DO - 10.1093/rheumatology/keae099

M3 - Erratum

C2 - 38335930

SN - 1462-0324

VL - 64

SP - 771

EP - 779

JO - Rheumatology (Oxford, England)

JF - Rheumatology (Oxford, England)

IS - 2

ER -

Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement

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Comment on: Immune checkpoint inhibitor-mediated polymyalgia rheumatica versus primary polymyalgia rheumatica: comparison of disease characteristics and treatment requirement. Reply

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