Prescribing for polymyalgia rheumatica

Abstract

Polymyalgia rheumatica is a common inflammatory condition but can be difficult to diagnose. Treatment is warranted in all cases to manage disabling symptoms. Low–moderate doses of oral corticosteroids are highly effective. Once symptoms improve they can often be gradually reduced over months, but most patients require either prolonged or continuous treatment. Despite their effectiveness, corticosteroids cause disproportionate damage in polymyalgia rheumatica compared to other rheumatic diseases. The therapeutic aim is to prescribe the minimum possible dose required for symptom control. There is a lack of definitive evidence for steroid-sparing drugs in polymyalgia rheumatica. Methotrexate is..