I read that article and found it discouraging. It's clear that much is still not well understood. It was quite technical, and I need to check on some definitions before I review it again.
The two things I took away from it is that now it is believed that PMR pts. have , subclinical GCA, and or will go on to to develop GCA and vice versa. He reminds us that emphasis on GCA has centered on the cranial symptoms; headaches and visual disturbances. It is more than that.
The writers remind us that GCA is large vessel inflammation which can be going on in the vessels in the chest, abdomen and GROIN,etc, not just the head. I know there was someone wondering about severe groin pain. Seems like a symptom of GCA (with PMR.)
The researchers thought that PMR and GCA symptoms overlap. There is a nice diagram showing the overlapping of GCA and PMR. It is as if PMR and GCA cannot be entirely separated.
The other point I noted was that he recommends Methotrexate only when a pt. has had a second relapse , and says nothing about using it as a steroid sparing treatment strategy. Azanthopine and other DMARDS were not even mentioned.
He also discussed Tocilimubab and one other "gevismubab" ? as still being under trials. I believe Tocilimubab is already in use.
That was 2 years ago so pretty recent. I thought to myself, Oh, great, there is still time for GCA to materialize in those of us who think of ourselves as PMR patients and vice versa.
They also advocate for a revision in EULAR diagnostic standards to aid in diagnostics. There is also a discussion about using ultrasound, MRI and PET scan as measures of inflammation. Neither rheumatologist I saw recommended US or PET scan, and a chest MRI was recommended, but never followed up by dr's office. And it takes forever to get approval for contrast to be used.
I also missed my chance for acute reagent testing (which must be done before taking Pred 2 weeks . ) The PA and family doctor holding down the rheumatogist's office simply forgot at my 2 week follow up to tell me or give me lab paperwork to have the acute reactant blood work, then tried to blame me for not getting it done at my 3rd visit.
I challenged him ,not too nicely , and I saw beads of sweat appear on his face. Too late now. I changed rheumatologists.
But the writers did say there is debate ongoing. I asked the neuroophthalmologist who evaluated me for temporary vision loss at a prestigious eye hospital in Philadelphia and made the comment that I had read that ophthalmologists were using infusions of Tocilimubab for GCA. His response was" it all depends on who you talk to." So there is clear uncertainty still within the research and medical community.