Management of difficult polymyalgia rheumatica and giant cell arteritis: Updates for clinical practice

Best Pract Res Clin Rheumatol. 2018 Dec;32(6):803-812. doi: 10.1016/j.berh.2019.04.006. Epub 2019 May 23.

Abstract

Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) represent a family of systemic inflammatory diseases occurring in adults aged 50 years and above. Clinical presentation of PMR/GCA can be variable, making diagnosis at times challenging. There has been an increased appreciation of the role of various large-vessel imaging modalities to help confirm a diagnosis of GCA. Systemic corticosteroids (CS) remain the mainstay of treatment for both PMR and GCA, yet both relapses and CS-related side effects are common. Recent research has demonstrated efficacy of certain biologic agents in these diseases, with particular emphasis on the role of interleukin-6 (IL-6) blockade in GCA. This chapter discusses the latest updates on the diagnosis and treatment of PMR/GCA, with an emphasis on clinical care.

Keywords: Biologics; Corticosteroids; Giant cell arteritis; Large-vessel vasculitis; Polymyalgia rheumatica.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / pharmacology
  • Adrenal Cortex Hormones / therapeutic use*
  • Aged
  • Giant Cell Arteritis / diagnosis*
  • Giant Cell Arteritis / drug therapy*
  • Giant Cell Arteritis / pathology
  • Humans
  • Middle Aged
  • Polymyalgia Rheumatica / diagnosis*
  • Polymyalgia Rheumatica / drug therapy*
  • Polymyalgia Rheumatica / pathology

Substances

  • Adrenal Cortex Hormones