Assessing disease activity in polymyalgia rheumatica: Is the treat-to-target concept feasible?
https://doi.org/10.47360/1995-4484-2026-32-38
Abstract
Polymyalgia rheumatica (PMR) is a prevalent immune-mediated inflammatory rheumatic disease that typically affects individuals over the age of 50. Despite significant advances in the diagnosis and treatment of PMR, challenges remain in the objective assessment of disease activity, which hinders the development and implementation of the treat-to-target (T2T) strategy. Diagnosis is primarily based on clinical symptoms and laboratory markers of inflammation—most notably, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). However, the diagnostic value of these markers is reduced in patients receiving interleukin-6 inhibitors, emphasizing the need for alternative biomarkers. The Polymyalgia Rheumatica Activity Score (PMR-AS) and its modifications (CRP-PMR-AS, ESR-PMR-AS, and clin-PMR-AS) are among the most thoroughly studied tools for the quantitative assessment of disease activity. The potential of imaging modalities such as ultrasound and magnetic resonance imaging (MRI) is also being actively explored for visualizing structural changes and assessing inflammatory activity in PMR. These techniques have demonstrated high sensitivity and specificity but require further standardization and validation of their clinical relevance. The development of a comprehensive monitoring strategy based on validated indices and objective biomarkers may serve as a foundation for the creation of national clinical guidelines and facilitate the successful implementation of the T2T approach in routine rheumatologic practice.
About the Authors
E. V. Arsenyev
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Competing Interests:
Russian Federation
Evgeniy V. Arsenyev
115522, Moscow, Kashirskoye Highway, 34A
Competing Interests:
None
A. D. Meshkov
Russian Gerontological Research and Clinical Center, N.I. Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Alexey D. Meshkov
129226, Moscow, 1-ya Leonova str., 16
Competing Interests:
None
A. L. Maslyanskiy
V.A. Nasonova Research Institute of Rheumatology ; Almazov National Medical Research Centre ; St. Petersburg State University
Russian Federation
Competing Interests:
Russian Federation
Alexey L. Maslyanskiy
115522, Moscow, Kashirskoye Highway, 34A
197341, Saint Petersburg, Akkuratova str., 2
199034, Saint Petersburg, Universitetskaya emb., 7-9
Competing Interests:
None
E. G. Zotkin
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Competing Interests:
Russian Federation
Evgeniy G. Zotkin
115522, Moscow, Kashirskoye Highway, 34A
Competing Interests:
None
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For citations:
Arsenyev E.V., Meshkov A.D., Maslyanskiy A.L., Zotkin E.G. Assessing disease activity in polymyalgia rheumatica: Is the treat-to-target concept feasible? Rheumatology Science and Practice. 2026;64(1):32-38. (In Russ.) https://doi.org/10.47360/1995-4484-2026-32-38
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