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Corticosteroid Treatment for Polymyalgia Rheumatica and Giant Cell Arteritis

Topic Overview

Although corticosteroid treatment for polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) is similar, there are differences in how much medicine you take, how long you may have to take it, and how you track the condition.

The following table shows general treatment guidelines for the two conditions.1

Treatment choices for PMR and GCA
  Polymyalgia rheumatica Giant cell arteritis

Amount of corticosteroid (usually prednisone) you take by mouth (oral) until you have no symptoms and have normal lab tests

  • 10–20 mg a day
  • 40–60 mg a day

How long it takes before symptoms go away or greatly improve

  • 2–7 days
  • 2–7 days

How long it takes for lab tests to become normal

  • Usually 2–3 weeks
  • 2–4 weeks or more

How often your doctor may reduce your dose after symptoms go away and lab tests are normal

  • Every 2–4 weeks at first, then less often
  • Every 2–4 weeks at first, then less often

How long you may take corticosteroids

  • Usually 1–2 years
  • About 1–2 years, but many people with the condition take them longer than 2 years

Your doctor will want to keep track of your condition and how it is responding to treatment. Stay in touch with your doctor or nurse while you are taking corticosteroids for polymyalgia rheumatica or giant cell arteritis. And keep in touch for 6 to 12 months after you stop taking this drug.

In both polymyalgia rheumatica and giant cell arteritis, your symptoms may return after a period of improvement (relapse). If you have a relapse, your doctor may increase your corticosteroid dosage for a period of time and then gradually reduce it after your symptoms are gone.

How long you need to take corticosteroids depends on how severe your condition is, whether it appears cured or not (remission), and how often you have relapses.

If you have polymyalgia rheumatica and do not have giant cell arteritis, your doctor may suggest using nonsteroidal anti-inflammatory drugs (NSAIDs) when you are lowering the dose of your corticosteroid medicine. Always talk to your doctor or nurse before using these medicines.

References

Citations

  1. Hellmann DB (2009). Giant cell arteritis, polymyalgia rheumatica, and Takayasu's arteritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 8th ed., vol. 2, pp. 1409–1428. Philadelphia: Saunders Elsevier.

Credits

By Healthwise Staff
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Stanford M. Shoor, MD - Rheumatology
Last Revised April 13, 2011

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