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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Buttgereit, F; Boyadzhieva, Z; Reisch, M; Schneider, M; Brabant, T; Daikeler, T; Duftner, C; Erstling, U; Garske, U; Hellmich, B; Kyburz, D; Reisshauer, A; Reuss-Borst, M; Scheuermann, K; Steffens-Korbanka, P; Matteson, EL; Dejaco, C.
Recommendations of the German, Austrian and Swiss rheumatology and other medical societies for the management of polymyalgia rheumatica
RHEUMATOLOGY. 2025; Doi: 10.1093/rheumatology/keaf646
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Führende Autor*innen der Med Uni Graz
Dejaco Christian
Co-Autor*innen der Med Uni Graz
Dejaco Christian
Reisch Myriam Katja
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Abstract:
Objectives Polymyalgia rheumatica (PMR) is the second most frequent inflammatory rheumatic disease in older adults, after rheumatoid arthritis. Recommendations for the management of PMR, developed by the German, Austrian and Swiss societies of rheumatology and other organizations were published in 2018.Methods These recommendations are now updated based on a systematic literature search that covered the evidence published between July 2016 and January 2024 on therapeutic interventions and prognostic factors for PMR. The search string followed that used in the original recommendations, with an extension for targeted synthetic disease-modifying antirheumatic drugs (DMARDs). Based on evidence and expert opinions, the task force (12 physicians, two healthcare professionals and two patients from three countries) developed a set of four overarching principles and seven specific recommendations.Results The current update reiterates previous guideline recommendations for glucocorticoids (15-25 mg prednisone equivalents per day) as initial treatment for PMR once diagnosis has been confirmed, with subsequent tapering over 4-12 months (depending on whether a glucocorticoid sparing agent is used), with monitoring of disease activity and treatment-related adverse effects. Interleukin-6 receptor blocking agents should be considered in addition to glucocorticoids in patients with relapsing disease and can be considered in patients with new-onset PMR at high risk for glucocorticoid-related adverse events. Methotrexate or rituximab may be alternatives. Older and frail patients should also be offered an individualized exercise program.Conclusion These updated recommendations should serve as an aid to evidence-based decisions ensuring high-quality care for all patients with PMR.

Find related publications in this database (Keywords)
inflammatory rheumatic diseases
treatment
disease activity glucocorticoids
evidence-based decisions
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