PMR Treatment Duration — SCE Rheumatology MCQ

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EasyVasculitisPMR Treatment DurationSCE Rheumatology

A 65-year-old man with PMR has been on Prednisolone for 6 months. His GP asks about the recommended duration of glucocorticoid therapy for PMR. What is the typical minimum treatment duration?

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Correct answer: B — 12-24 months minimum

PMR typically requires glucocorticoid therapy for a minimum of 12-24 months with gradual tapering. BSR PMR guidelines recommend reducing the dose by no more than 1 mg per month once below 10 mg. Approximately 25-50% of patients relapse during tapering requiring dose increase. Some patients require treatment for several years. Complete withdrawal is not possible in all patients. The relapse rate is highest during the first 18 months. IL-6 inhibitors (Tocilizumab) and Methotrexate may be considered as steroid-sparing agents in relapsing PMR though evidence is limited.

Reference: BSR 2010 PMR guidelines; Dasgupta B et al 2012 ACR/EULAR PMR criteria