Course of Polymyalgia Rheumatica

What is the course of Polymyalgia Rheumatica?

The course of PMR is longer and recurrences are more frequent than once believed. Possible predictors of a poor clinical course include:

• An older age at diagnosis,

• Female sex, and

• Very high ESR/CRP with failure to normalize the CRP within 1 week of starting prednisone. About 75% of patients are able to taper off their prednisone within 2 years. However, 25% to 35% of patients require low doses of GCs indefinitely due to recurrent relapse each time the prednisone is tapered. In those who are able to have their GCs stopped, relapses of PMR can occur in 10% to 20% of patients within months or after several years. In these patients, the ESR may not be as high as with the original presentation.

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