2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative
Christian Dejaco, Yogesh P Singh, Pablo Perel, Andrew Hutchings, Dario Camellino, Sarah Mackie, Andy Abril, Artur Bachta, Peter Balint, Kevin Barraclough, Lina Bianconi, Frank Buttgereit, Steven Carsons, Daniel Ching, Maria Cid, Marco Cimmino, Andreas Diamantopoulos, William Docken, Christina Duftner, Billy Fashanu, Kate Gilbert, Pamela Hildreth, Jane Hollywood, David Jayne, Manuella Lima, Ajesh Maharaj, Christian Mallen, Victor Martinez-Taboada, Mehrdad Maz, Steven Merry, Jean Miller, Shunsuke Mori, Lorna Neill, Elisabeth Nordborg, Jennifer Nott, Hannah Padbury, Colin Pease, Carlo Salvarani, Michael Schirmer, Wolfgang Schmidt, Robert Spiera, David Tronnier, Alexandre Wagner, Madeline Whitlock, Eric L Matteson, Bhaskar Dasgupta, European League Against Rheumatism, American College of Rheumatology, Christian Dejaco, Yogesh P Singh, Pablo Perel, Andrew Hutchings, Dario Camellino, Sarah Mackie, Andy Abril, Artur Bachta, Peter Balint, Kevin Barraclough, Lina Bianconi, Frank Buttgereit, Steven Carsons, Daniel Ching, Maria Cid, Marco Cimmino, Andreas Diamantopoulos, William Docken, Christina Duftner, Billy Fashanu, Kate Gilbert, Pamela Hildreth, Jane Hollywood, David Jayne, Manuella Lima, Ajesh Maharaj, Christian Mallen, Victor Martinez-Taboada, Mehrdad Maz, Steven Merry, Jean Miller, Shunsuke Mori, Lorna Neill, Elisabeth Nordborg, Jennifer Nott, Hannah Padbury, Colin Pease, Carlo Salvarani, Michael Schirmer, Wolfgang Schmidt, Robert Spiera, David Tronnier, Alexandre Wagner, Madeline Whitlock, Eric L Matteson, Bhaskar Dasgupta, European League Against Rheumatism, American College of Rheumatology
Abstract
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.
Keywords: Corticosteroids; Giant Cell Arteritis; Patient perspective; Polymyalgia Rheumatica; Treatment.
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Source: PubMed