Skip to main content
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1983 Aug;42(4):374–378. doi: 10.1136/ard.42.4.374

Polymyalgia rheumatica and corticosteroids: how much for how long?

A R Behn, T Perera, A B Myles
PMCID: PMC1001245  PMID: 6882032

Abstract

In a prospective study of 176 patients in whom polymyalgia rheumatica (PMR) or giant cell arteritis (GCA) had been diagnosed between 1968 and 1980 the effect of corticosteroid treatment was studied. In those with PMR alone an initial regimen of 10 mg prednisolone daily and for the majority of those with GCA 20 mg daily were adequate to control symptoms. No patient suffered a serious disease complication after starting treatment. Regular follow-up enabled the minimum effective corticosteroid dose to be used. Complications of treatment were infrequent. Corticosteroid treatment has been withdrawn from 72 patients after a mean of 31 months treatment (range 3-103 months). Thirty subsequently relapsed, all within 21 months of withdrawal. No clinical feature predicted those who were more likely to relapse. No rigid treatment schedule should be used in these diseases.

Full text

PDF
374

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BAGRATUNI L. Prognosis in the anarthritic rheumatoid syndrome. Br Med J. 1963 Feb 23;1(5329):513–518. doi: 10.1136/bmj.1.5329.513. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BIRKHEAD N. C., WAGENER H. P., SHICK R. M. Treatment of temporal arteritis with adrenal corticosteroids; results in fifty-five cases in which lesion was proved at biopsy. J Am Med Assoc. 1957 Mar 9;163(10):821–827. doi: 10.1001/jama.1957.02970450023007. [DOI] [PubMed] [Google Scholar]
  3. Blajchman M. A., Senyi A. F., Hirsh J., Surya Y., Buchanan M., Mustard J. F. Shortening of the bleeding time in rabbits by hydrocortisone caused by inhibition of prostacyclin generation by the vessel wall. J Clin Invest. 1979 May;63(5):1026–1035. doi: 10.1172/JCI109371. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Coomes E. N., Ellis R. M., Kay A. G. A prospective study of 102 patients with the polymyalgia rheumatica syndrome. Rheumatol Rehabil. 1976 Nov;15(4):270–279. doi: 10.1093/rheumatology/15.4.270. [DOI] [PubMed] [Google Scholar]
  5. David D. S., Berkowitz J. S. Ocular effects of topical and systemic corticosteroids. Lancet. 1969 Jul 19;2(7612):149–151. doi: 10.1016/s0140-6736(69)92454-4. [DOI] [PubMed] [Google Scholar]
  6. Fainaru M., Friedman G., Friedman B. Temporal arteritis in Israel. A review of 47 patients. J Rheumatol. 1979 May-Jun;6(3):330–335. [PubMed] [Google Scholar]
  7. Fauchald P., Rygvold O., Oystese B. Temporal arteritis and polymyalgia rheumatica. Clinical and biopsy findings. Ann Intern Med. 1972 Dec;77(6):845–852. doi: 10.7326/0003-4819-77-6-845. [DOI] [PubMed] [Google Scholar]
  8. Fernandez-Herlihy L. Duration of corticosteroid therapy in giant cell arteritis. J Rheumatol. 1980 May-Jun;7(3):361–364. [PubMed] [Google Scholar]
  9. Graham E., Holland A., Avery A., Russell R. W. Prognosis in giant-cell arteritis. Br Med J (Clin Res Ed) 1981 Jan 24;282(6260):269–271. doi: 10.1136/bmj.282.6260.269. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hamilton C. R., Jr, Shelley W. M., Tumulty P. A. Giant cell arteritis: including temporal arteritis and polymyalgia rheumatica. Medicine (Baltimore) 1971 Jan;50(1):1–27. [PubMed] [Google Scholar]
  11. Huston K. A., Hunder G. G., Lie J. T., Kennedy R. H., Elveback L. R. Temporal arteritis: a 25-year epidemiologic, clinical, and pathologic study. Ann Intern Med. 1978 Feb;88(2):162–167. doi: 10.7326/0003-4819-88-2-162. [DOI] [PubMed] [Google Scholar]
  12. Jones J. G., Hazleman B. L. Prognosis and management of polymyalgia rheumatica. Ann Rheum Dis. 1981 Feb;40(1):1–5. doi: 10.1136/ard.40.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Klein R. G., Campbell R. J., Hunder G. G., Carney J. A. Skip lesions in temporal arteritis. Mayo Clin Proc. 1976 Aug;51(8):504–510. [PubMed] [Google Scholar]
  14. Meadows S. P. Temporal or giant cell arteritis. Proc R Soc Med. 1966 Apr;59(4):329–334. [PMC free article] [PubMed] [Google Scholar]
  15. Mowat A. G., Hazleman B. L. Polymyalgia rheumatica -- a clinical study with particular reference to arterial disease. J Rheumatol. 1974 Jun;1(2):190–202. [PubMed] [Google Scholar]
  16. Myles A. B. Polymyalgia rheumatica and giant cell arteritis: a seven-year survey. Rheumatol Rehabil. 1975 Nov;14(4):231–235. doi: 10.1093/rheumatology/14.4.231. [DOI] [PubMed] [Google Scholar]
  17. O'Duffy J. D., Hunder G. G., Wahner H. W. A follow-up study of polymyalgia rheumatica: evidence of chronic axial synovitis. J Rheumatol. 1980 Sep-Oct;7(5):685–693. [PubMed] [Google Scholar]
  18. PAULLEY J. W., HUGHES J. P. Giant-cell arteritis, or arteritis of the aged. Br Med J. 1960 Nov 26;2(5212):1562–1567. doi: 10.1136/bmj.2.5212.1562. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. SCHMID F. R., COOPER N. S., ZIFF M., McEWEN C. Arteritis in rheumatoid arthritis. Am J Med. 1961 Jan;30:56–83. doi: 10.1016/0002-9343(61)90064-x. [DOI] [PubMed] [Google Scholar]
  20. Spiera H., Davison S. Long-term follow-up of polymyalgia rheumatica. Mt Sinai J Med. 1978 Mar-Apr;45(2):225–229. [PubMed] [Google Scholar]
  21. von Knorring J. Treatment and prognosis in polymyalgia rheumatica and temporal arteritis. A ten-year survey of 53 patients. Acta Med Scand. 1979;205(5):429–435. doi: 10.1111/j.0954-6820.1979.tb06077.x. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES