Glucocorticoids for Management of Polymyalgia Rheumatica and Giant Cell Arteritis

Rheum Dis Clin North Am. 2016 Feb;42(1):75-90, viii. doi: 10.1016/j.rdc.2015.08.009.

Abstract

Diagnosis of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) is based on typical clinical, histologic, and laboratory features. Ultrasonographic imaging in PMR with assessment especially of subdeltoid bursitis can aid in diagnosis and in following response to treatment. In GCA, diagnosis and disease activity are supported with ultrasonographic, MRI, or [(18)F]fluorodeoxyglucose PET evaluation of large vessels. Glucocorticoids are the primary therapy for PMR and GCA. Methotrexate may be used in patients at high risk for glucocorticoid adverse effects and patients with frequent relapse or needing protracted therapy. Other therapeutic approaches including interleukin 6 antagonists are under evaluation.

Keywords: Giant cell arteritis; Glucocorticoids; Polymyalgia rheumatica; Treatment.

Publication types

  • Review

MeSH terms

  • Disease Management
  • Giant Cell Arteritis / diagnosis
  • Giant Cell Arteritis / drug therapy*
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Methotrexate / therapeutic use
  • Polymyalgia Rheumatica / diagnosis
  • Polymyalgia Rheumatica / drug therapy*
  • Shoulder Joint / diagnostic imaging
  • Temporal Arteries / diagnostic imaging
  • Temporal Arteries / pathology
  • Ultrasonography

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Methotrexate