New Drug Combination Eases Relapsed Joint Condition, Trial Finds

Polymyalgia rheumatica (PMR) is a condition causing pain and stiffness in the shoulders, neck, and hips, typically affecting people over 50. It’s usually managed with steroid tablets called glucocorticoids — but relapses are common, and finding better ways to treat them has been a long-standing challenge. Results from the REPLENISH trial, published in the New England Journal of Medicine, now suggest a combination approach may offer patients a better chance of sustained remission.

The trial tested two doses of secukinumab against a placebo, with all groups also receiving a 24-week steroid taper, in patients whose PMR had relapsed. Secukinumab is a drug that targets a protein involved in inflammation. Patients given secukinumab alongside the steroid course reached remission at a higher rate than those on steroids alone, according to the published results.

Secukinumab is already licensed in the UK for conditions including psoriatic arthritis and ankylosing spondylitis (a type of inflammatory back disease). Its potential role in PMR would represent a new use of the drug, though any change to prescribing practice in NHS services would require review by bodies such as the National Institute for Health and Care Excellence (NICE).

The REPLENISH findings are phase 3 results — the most advanced stage of clinical testing before regulatory consideration. That doesn’t mean the treatment will reach patients immediately. But for the tens of thousands of people diagnosed with PMR in the UK each year, many of whom experience relapses despite steroid treatment, the results add to a growing evidence base for alternatives.

Anyone in Kent experiencing symptoms of PMR — persistent aching or stiffness in the shoulders, upper arms, or hips, chiefly in the morning — should speak to their GP rather than self-diagnosing. For general health queries, NHS 111 is available by phone or online.