Prescribing for polymyalgia rheumatica

Analysis of Treatment of Polymyalgia Rheumatica

“…When a dose of 10 mg is achieved by a patient, tapering changes to a decreasing increment of 1 mg every 1-2 months until off all together [1]. A regimen has been proposed by the British Society of Rheumatology, which says that prednisolone should be taken over the course of 3 weeks at doses of 15 mg daily [10]. In terms of tapering, the dose should be lowered to 12.5 mg daily for another 3 weeks, which is followed up by a dose of 10 mg daily for an additional 4-6 weeks, and finally a reduction of 1 mg daily for the final 4-8 weeks [10].…”

“…A regimen has been proposed by the British Society of Rheumatology, which says that prednisolone should be taken over the course of 3 weeks at doses of 15 mg daily [10]. In terms of tapering, the dose should be lowered to 12.5 mg daily for another 3 weeks, which is followed up by a dose of 10 mg daily for an additional 4-6 weeks, and finally a reduction of 1 mg daily for the final 4-8 weeks [10]. Tapering schedules vary depending on the source, but in the end show similarities in terms of the doses given to patients.…”

“…Many times, patients must stay on glucocorticoids for extended periods of time due to relapse once tapering of medications begins. Relapse can be defined as the reappearance of symptoms and elevated inflammatory markers, which requires raising the dose of prednisone back to the previous efficacious dose before tapering occurred [10]. A study of 57 PMR patients described a greater risk of relapse if findings of a positive power Doppler show inflammation in the shoulders [1].…”