Polymyalgia rheumatica and giant-cell arteritis
Open accessAbstract
Polymyalgia rheumatica and giant-cell arteritis are closely related disorders that affect people of middle age and older. They frequently occur together. Both are syndromes of unknown cause, but genetic and environmental factors might have a role in their pathogenesis. The symptoms of polymyalgia rheumatica seem to be related to synovitis of proximal joints and extra-articular synovial structures. Giant-cell arteritis primarily affects the aorta and its extracranial branches. The clinical findings in giant-cell arteritis are broad, but commonly include visual loss, headache, scalp tenderness, jaw claudication, cerebrovascular accidents, aortic arch syndrome, thoracic aorta aneurysm, and dissection. Glucocorticosteroids are the cornerstone of treatment of both polymyalgia rheumatica and giant-cell arteritis. Some patients have a chronic course and might need glucocorticosteroids for several years. Adverse events of glucocorticosteroids affect more than 50% of patients. Trials of steroid-sparing drugs have yielded conflicting results. A greater understanding of the molecular mechanisms involved in the pathogenesis should provide new targets for therapy.
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The efficacy of low-dose GCs (≤7.5 mg prednisolone equivalent daily) on disease activity in various conditions is well established.
“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 [3]
Glucocorticoids are the cornerstone in the treatment of numerous chronic autoimmune and inflammatory diseases, including rheumatoid arthritis, polymyalgia rheumatica, giant cell arteritis, systemic lupus erythematosus and inflammatory bowel diseases.
“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 [3]
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Chaudhry, I. A., Shamsi, F. A., Elzaridi, E., et al. (2007) · British Journal of Ophthalmology · doi:10.1136/bjo.2006.108845 · Cited by 50 · see citing works
Fever in biopsy‐proven giant cell arteritis: Clinical implications in a defined population
González-Gay, M. Á., Garcı́a-Porrúa, C., Amor‐Dorado, J. C., et al. (2004) · Arthritis Care & Research · doi:10.1002/art.20523 · Cited by 49 · see citing works
Olivieri, I., Garcı́a-Porrúa, C., Padula, A. A., et al. (2007) · Rheumatology International · doi:10.1007/s00296-007-0331-8 · Cited by 48 · see citing works
Nuclear antigen histone H1 is primarily involved in lupus erythematosus cell formation
Schett, G. A., Steiner, G. E., & Smolen, J. S. (1998) · Arthritis & Rheumatism · doi:10.1002/1529-0131(199808)41:8 · Cited by 44 · see citing works
Development and preliminary validation of a Children's Arthritis Self-Efficacy Scale
Barlow, J., Shaw, K. L., & Wright, C. C. (2001) · Arthritis & Rheumatism · doi:10.1002/1529-0131(200104)45:2 · Cited by 39 · see citing works
Are steroids alone sufficient for the treatment of giant cell arteritis?
Pipitone, N., Boiardi, L., & Salvarani, C. (2005) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2004.10.002 · Cited by 32 · see citing works
Self-citationPericardial and pleural effusion in giant cell arteritis
Valstar, M. H., Terpstra, W. F., & de Jong, R. S. (2003) · The American Journal of Medicine · doi:10.1016/s0002-9343(03)00134-7 · Cited by 19 · see citing works
Renal cell carcinoma mimicking polymyalgia rheumatica
Niccoli, L., Salvarani, C., Baroncelli, G., et al. (2002) · Scandinavian Journal of Rheumatology · doi:10.1080/03009740252937649 · Cited by 19 · see citing works
Self-citationSalvarani, C. (1997) · IRIS UNIMORE (University of Modena and Reggio Emilia) · Cited by 19 · see citing works
Self-citationPolymyositis, not polymyalgia rheumatica.
Hopkinson, N., Shawe, D., & Gumpel, J. M. (1991) · Annals of the Rheumatic Diseases · doi:10.1136/ard.50.5.321 · Cited by 14 · see citing works
Pope (2001) · doi:10.1002/1529-0131(200106)44:6
Komuro (2001) · doi:10.1002/1529-0131(200112)44:12
Santiago (2001) · doi:10.1002/1529-0131(200107)44:7
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Hayreh, S. S. (2009) · Progress in Retinal and Eye Research · doi:10.1016/j.preteyeres.2008.11.002 · Cited by 656 · see citing works
Haanen, J., Ernstoff, M. S., Wang, Y., Menzies, A. M., Puzanov, I., Grivas, P., Larkin, J., Peters, S., Thompson, J. A., & Obeid, M. (2020) · Annals of Oncology · doi:10.1016/j.annonc.2020.03.285 · Cited by 222 · see citing works
Hasegawa, H., Mizoguchi, I., Chiba, Y., Ohashi, M., Xu, M., & Yoshimoto, T. (2016) · Frontiers in Immunology · doi:10.3389/fimmu.2016.00479 · Cited by 142 · see citing works
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 · see citing works
- Authors
- Salvarani, C., Cantini, F., & Hunder, G. G.
- Affiliations
- Santa Maria Nuova Hospital (IT)
- Ospedale di Prato Santo Stefano (IT)
- Mayo Clinic (US)
- Corresponding author
- Salvarani, Carlo
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2008-07
- Volume
- 372
- Issue
- 9634
- Pages
- 234-245
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W4296590630
- Cited by
- 767
- References
- 114
- Citations by year
- 2026: 33 · 2025: 26 · 2024: 41 · 2023: 51 · 2022: 32 · 2021: 56 · 2020: 42 · 2019: 51 · 2018: 45 · 2017: 47 · 2016: 48 · 2015: 34 · 2014: 39 · 2013: 38 · 2012: 53
- FWCI
- 6.54
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vasculitis and related conditions
- Health Sciences › Medicine › Rheumatology › Otitis Media and Relapsing Polychondritis
- Health Sciences › Medicine › Epidemiology › Autoimmune and Inflammatory Disorders
- Keywords
- polymyalgia rheumatica, giant cell arteritis, pathogenesis, glucocorticoid therapy, glucocorticoid adverse effects, synovitis, aortic involvement, vision loss, jaw claudication, aortic aneurysm, aortic dissection, middle-aged and older adults
- MeSH terms
- Aged, Diagnosis, Differential, Female, Glucocorticoids, Humans, Male, Middle Aged, Polymyalgia Rheumatica, Giant Cell Arteritis, Incidence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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