Corticosteroid Requirements in Polymyalgia Rheumatica

Abstract

Polymyalgia rheumatica is a heterogeneous disease with variations in the treatment duration and dose of corticosteroids required for suppression of symptoms. Pretreatment erythrocyte sedimentation rate and nonresponsiveness of interleukin 6 to steroid therapy are helpful in dividing patients into subsets with different treatment requirements.

“I suddenly felt I’d aged”: A qualitative study of patient experiences of polymyalgia rheumatica (PMR)

“…The results from this study support previous findings of the heterogeneity of PMR which contributes to the complexity of diagnosis and assessment of disease activity [3,19]. The terminology used when discussing symptoms is important in achieving a shared understanding between doctor and patient and enabling a correct diagnosis.…”

“…In cases where there was a perceived delay in diagnosis, this anxiety was exacerbated. The symptoms of PMR have a wide differential diagnosis and controversy still exists as to the defining characteristics of the condition [19]. The diagnosis is often made over a series of consultations forming a process which may include an initial trial of treatment [8].…”

Clinical outcomes, quality of life, and diagnostic uncertainty in the first year of polymyalgia rheumatica

“…There is little evidence on what constitutes a typical response and how it relates to longer-term outcomes or revisions of the initial diagnosis. A study of 27 patients proposed 3 categories of disease course: a rapid response without significant relapse, a rapid response requiring extended treatment, and incomplete resolution of symptoms requiring extended steroid treatment (17). Accurate disease assessment and patient-based outcomes are critical to balance the benefits versus serious adverse outcomes of steroid therapy (18).…”

Serum Amyloid A as a Potent Therapeutic Marker in a Refractory Patient with Polymyalgia Rheumatica

“…Corticosteroid therapy usually shows good therapeutic effects at a low to moderate dosage within a week after initiation in PMR, but in some cases muscle symptoms persist even though C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) return to the normal range (4,5). In such a case, serum amyloid A (SAA) has been recently reported as a useful marker for evaluating the degree of active tenosynovitis (5,6).…”