ACR EULAR expert panel Polymyalgia Rheumatica treatment recommendations
How does the ACR EULAR expert panel recommend treating PMR?
The panel recommends for:
• A single daily dose of 12.5 to 25 mg prednisone or equivalent dose of another GC as the initial treatment of PMR using the minimum effective individualized duration, or
• Intramuscular methylprednisolone 120 mg every 3 weeks as an alternative to oral prednisone, and
• Early utilization of methotrexate (MTX) 7.5 to 10 mg/week in addition to GCs, particularly in patients who are unable to adequately taper GC or who are at significant risk for GC-related adverse events (e.g., diabetes mellitus and osteoporosis). Note that other studies have used MTX doses up to 20 mg/week.
• Individualized exercise programs aimed at maintenance of muscle mass and function and reducing risk of falls, especially frail older patients on long-term steroids.
• The panel strongly recommends against tumor necrosis factor antagonists and Chinese herbal supplements.
