Treatment

A dramatic improvement in symptoms following treatment with steroids (10 to 15mg Prednisolone per day) may occur in Polymyalgia Rheumatica and this dose will be sufficient for 80% of cases.

Improvement normally occurs within 72 hours. After a month of treatment, the dose is reduced to about 10mg per day and then gradually reduced further over the following months.

The average period of time spent on steroids is around 2 years but some people require a continuing dose for up to 5 years and the disease may relapse once the steroid treatment is stopped.

Though relapse would not be immediate, 15% to 20% of patients will have a second attack.

Azathioprine may also be used if the person is likely to need more than 7.5mg of steroids per day as a maintenance dose or if large doses of steroids are needed.

This is to reduce the danger of side effects (such as the development of osteoporosis or Cushing’s syndrome) developing from long – term higher dose steroid use.

When the daily dose of steroids is around 10mg, the patients should all be on bone-protective medication such as calcium and Vitamin D3 and a biphosphonate (such as disodium etidronate) to prevent osteoporosis. All patients over 70 years of age will need it and it should be considered under the age of 70 years too.

The dose is reduced according to symptoms.

Amended November 2008