2015 Recommendations for the Management of Polymyalgia Rheumatica: A European League Against Rheumatism/American College of Rheumatology Collaborative Initiative

Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the mana...

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Published in:Arthritis & rheumatology (Hoboken, N.J.) N.J.), 2015-10, Vol.67 (10), p.2569-2580
Main Authors: Dejaco, Christian, Singh, Yogesh P., Perel, Pablo, Hutchings, Andrew, Camellino, Dario, Mackie, Sarah, Abril, Andy, Bachta, Artur, Balint, Peter, Barraclough, Kevin, Bianconi, Lina, Buttgereit, Frank, Carsons, Steven, Ching, Daniel, Cid, Maria, Cimmino, Marco, Diamantopoulos, Andreas, Docken, William, Duftner, Christina, Fashanu, Billy, Gilbert, Kate, Hildreth, Pamela, Hollywood, Jane, Jayne, David, Lima, Manuella, Maharaj, Ajesh, Mallen, Christian, Martinez‐Taboada, Victor, Maz, Mehrdad, Merry, Steven, Miller, Jean, Mori, Shunsuke, Neill, Lorna, Nordborg, Elisabeth, Nott, Jennifer, Padbury, Hannah, Pease, Colin, Salvarani, Carlo, Schirmer, Michael, Schmidt, Wolfgang, Spiera, Robert, Tronnier, David, Wagner, Alexandre, Whitlock, Madeline, Matteson, Eric L., Dasgupta, Bhaskar
Format: Article
Language:English
Subjects:
Antirheumatic Agents - adverse effects
Antirheumatic Agents - therapeutic use
Europe
Glucocorticoids - adverse effects
Glucocorticoids - therapeutic use
Humans
Polymyalgia Rheumatica - drug therapy
Rheumatism
Rheumatology
Risk Factors
United States
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Summary:Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the management of PMR. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology as a framework for the project. Accordingly, the direction and strength of the recommendations are based on the quality of evidence, the balance between desirable and undesirable effects, patients’ and clinicians’ values and preferences, and resource use. Eight overarching principles and nine specific recommendations were developed covering several aspects of PMR, including basic and follow‐up investigations of patients under treatment, risk factor assessment, medical access for patients and specialist referral, treatment strategies such as initial glucocorticoid (GC) doses and subsequent tapering regimens, use of intramuscular GCs and disease modifying anti‐rheumatic drugs (DMARDs), as well as the roles of non‐steroidal anti‐rheumatic drugs and non‐pharmacological interventions. These recommendations will inform primary, secondary and tertiary care physicians about an international consensus on the management of PMR. These recommendations should serve to inform clinicians about best practices in the care of patients with PMR.
ISSN:2326-5191
2326-5205
DOI:10.1002/art.39333