The DOI matches its Crossref record; 50 of the 50 references it cites were found in a registry or an index.
Treatment of Polymyalgia Rheumatica: A Systematic Review
Abstract
BACKGROUND: Polymyalgia rheumatica (PMR) treatment is based on low-dose glucocorticoids. Glucocorticoid-sparing agents have also been tested. Our objective was to systematically examine the peer-reviewed literature on PMR therapy, particularly the optimal glucocorticoid type, starting doses, and subsequent reduction regimens as well as glucocorticoid-sparing medications. METHODS: We searched Cochrane Databases and MEDLINE (1957 through December 2008) for English-language articles on PMR treatment (randomized trials, prospective cohorts, case-control trials, and case series) that included 20 or more patients. All data on study design, PMR definition criteria, medical therapy, and disease outcomes were collected using a standardized protocol. RESULTS: Thirty studies (13 randomized trials and 17 observational studies) were analyzed. No meta-analyses or systematic reviews were found. The PMR definition criteria, treatment protocols, and outcome measures differed widely among the trials. Starting prednisone doses higher than 10 mg/d were associated with fewer relapses and shorter therapy than were lower doses; starting prednisone doses of 15 mg/d or lower were associated with lower cumulative glucocorticoid doses than were higher starting prednisone doses; and starting prednisone doses higher than 15 mg/d were associated with more glucocorticoid-related adverse effects. Slow prednisone dose tapering (<1 mg/mo) was associated with fewer relapses and more frequent glucocorticoid treatment cessation than faster tapering regimens. Initial addition of oral or intramuscular methotrexate provided efficacy at doses of 10 mg/wk or higher. Infliximab was ineffective as initial cotreatment. CONCLUSIONS: The scarcity of randomized trials and the high level of heterogeneity of studies on PMR therapy do not allow firm conclusions to be drawn. However, PMR remission seems to be achieved with prednisone treatment at a dose of 15 mg/d in most patients, and reductions below 10 mg/d should preferably follow a tapering rate of less than 1 mg/mo. Methotrexate seems to exert glucocorticoid-sparing properties.
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“Although the efficacy of these doses on disease activity in various conditions is well established [1–4, 7]”
From Low-dose glucocorticoid treatment affects multiple aspects of intermediary metabolism in healthy humans: a randomised controlled trial (2011) · cites this paper as [2]
In the citing paper
“Glucocorticoids (GCs) are the cornerstone in the treatment of numerous chronic autoimmune and inflammatory diseases, including rheumatoid arthritis [1], polymyalgia rheumatica [2] and giant cell arteritis [3], systemic lupus erythematosus [4] and inflammatory bowel diseases [5].”
From Low-dose glucocorticoid treatment affects multiple aspects of intermediary metabolism in healthy humans: a randomised controlled trial (2011) · cites this paper as [2]
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Cites
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Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
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Polymyalgia Rheumatica and Giant-Cell Arteritis
Salvarani, C., Cantini, F., Boiardi, L., & Hunder, G. G. (2002) · New England Journal of Medicine · doi:10.1056/nejmra011913 · Cited by 1,352
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Ettlinger, R. E., Hunder, G. G., & Ward, L. E. (1978) · Annual Review of Medicine · doi:10.1146/annurev.me.29.020178.000311 · Cited by 687
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Bird, H. A., Esselinckx, W., Dixon, A. S., Mowat, A. G., & Wood, P. H. (1979) · Annals of the Rheumatic Diseases · doi:10.1136/ard.38.5.434 · Cited by 490
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Cited by
Brahmer, J. R., Abu-Sbeih, H., Ascierto, P. A., Brufsky, J., Cappelli, L. C., Cortazar, F. B., Gerber, D. E., Hamad, L., Hansen, E., Johnson, D. B., et al. (2021) · Journal for ImmunoTherapy of Cancer · doi:10.1136/jitc-2021-002435 · Cited by 917
Paraneoplastic Syndromes: An Approach to Diagnosis and Treatment
Pelosof, L. C., & Gerber, D. E. (2010) · Mayo Clinic Proceedings · doi:10.4065/mcp.2010.0099 · Cited by 773
van Raalte, D. H., Brands, M., van der Zijl, N. J., Muskiet, M. H., Pouwels, P. J. W., Ackermans, M. T., Sauerwein, H. P., Serlie, M. J., & Diamant, M. (2011) · Diabetologia · doi:10.1007/s00125-011-2174-9 · Cited by 109
“Glucocorticoids (GCs) are the cornerstone in the treatment of numerous chronic autoimmune and inflammatory diseases, including rheumatoid arthritis [1], polymyalgia rheumatica [2] and giant cell arteritis [3], systemic lupus erythematosus [4] and inflammatory bowel diseases [5].”
Background
Metadata
- Authors
- Hernández-Rodríguez, J.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2009-11-09
- Volume
- 169
- Issue
- 20
- Pages
- 1839
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1967784397
- Cited by
- 118
- References
- 50
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 6 · 2023: 3 · 2022: 3 · 2021: 4 · 2020: 6 · 2019: 4 · 2018: 6 · 2017: 9 · 2016: 4 · 2015: 11 · 2014: 6 · 2013: 18 · 2012: 18
- FWCI
- 9.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Vasculitis and related conditions
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Rheumatology › Otitis Media and Relapsing Polychondritis
- Keywords
- polymyalgia rheumatica, prednisone, glucocorticoid dose, glucocorticoid tapering, glucocorticoid-sparing agents, methotrexate, infliximab, relapse, glucocorticoid adverse effects, treatment discontinuation
- MeSH terms
- Aged, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Glucocorticoids, Humans, Long-Term Care, Male, Middle Aged, Pain Measurement, Polymyalgia Rheumatica, Prednisone, Quality of Life, Severity of Illness Index, Case-Control Studies, Randomized Controlled Trials as Topic, Treatment Outcome, Patient Satisfaction, Risk Assessment
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Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
