PMR Starting Dose — SCE Rheumatology MCQ
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Correct answer: C — 15 mg daily (range 12.5-25 mg)
BSR and EULAR PMR guidelines recommend starting Prednisolone at 12.5-25 mg daily (typically 15 mg) for PMR. A dramatic and rapid response (>70% improvement within 1 week) is expected and helps confirm the diagnosis. Failure to respond suggests an alternative diagnosis (late-onset RA malignancy GCA). The starting dose for PMR is much lower than for GCA (40-60 mg). Tapering should begin after 2-4 weeks of symptom control and is typically gradual over 12-24 months. Relapse on tapering is common and should prompt reassessment for GCA.
Reference: BSR 2010 PMR guidelines; Dasgupta B et al 2012 ACR/EULAR PMR criteria