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Glucocorticoids for Management of Polymyalgia Rheumatica and Giant Cell Arteritis

2015; Elsevier BV; Volume: 42; Issue: 1 Linguagem: Inglês

10.1016/j.rdc.2015.08.009

1558-3163

Eric L. Matteson, Frank Buttgereit, Christian Dejaco, Bhaskar Dasgupta,

Coagulation, Bradykinin, Polyphosphates, and Angioedema

Diagnosis of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) is based on typical clinical, histologic, and laboratory features. Ultrasonographic imaging in PMR with assessment especially of subdeltoid bursitis can aid in diagnosis and in following response to treatment. In GCA, diagnosis and disease activity are supported with ultrasonographic, MRI, or [(18)F]fluorodeoxyglucose PET evaluation of large vessels. Glucocorticoids are the primary therapy for PMR and GCA. Methotrexate may be used in patients at high risk for glucocorticoid adverse effects and patients with frequent relapse or needing protracted therapy. Other therapeutic approaches including interleukin 6 antagonists are under evaluation.