RhAPPcast: Foundations of PMR: Diagnosis, First-Line Therapy, and Tapering Strategies

In this episode of RhAPPcast, the official podcast of Rheumatology Advanced Practice Providers (RhAPP), host Amanda Mixon, PA-C, is joined by seasoned rheumatology expert Heather Mambretti, PA-C, for a comprehensive discussion on polymyalgia rheumatica (PMR). Together, they explore foundational concepts and clinical challenges, including how to accurately diagnose PMR, differentiate it from mimickers like rheumatoid arthritis and paraneoplastic syndromes, and initiate appropriate glucocorticoid therapy. Heather shares her evidence-based strategies for starting and tapering steroids, tips for monitoring disease activity, and how to manage relapses and comorbidities in older adults. The conversation also delves into steroid-sparing options, with a special focus on sarilumab — the first FDA-approved biologic for PMR—and how it’s being used in real-world practice to reduce steroid burden. Listeners will gain practical insights into lab evaluation, red flags during treatment, and key counseling points for long-term care. The episode wraps with a preview of the upcoming RhAPP National Conference in Denver, featuring bootcamps on IMIDs, obesity, IL management, and ultrasound skills. Whether you're a rheumatology APP, student, or seasoned provider, this episode offers expert-level guidance for navigating the nuances of PMR care.