In polymyalgia rheumatica, what is the typical response and duration of corticosteroid therapy?

In polymyalgia rheumatica, what is the typical response and duration of corticosteroid therapy?

• A. Rapid response within a few days; usually continued 1-2 years with taper
• B. Slow response over months; therapy longer than 5 years
• C. No response to steroids
• D. Requires high-dose steroids for years without taper

Answer: (A)

In polymyalgia rheumatica, the inflammatory process responds quickly to glucocorticoids, so relief of proximal girdle pain and stiffness typically occurs within days of starting treatment. Because the goal is to control inflammation while minimizing steroid exposure, the usual plan is to taper over a prolonged period, commonly 1–2 years, rather than stopping abruptly or using high-dose steroids indefinitely. This approach balances effective symptom control with reducing long-term steroid risks. Starting doses are modest (often around 15–20 mg of prednisone daily) and then tapered as symptoms and inflammatory markers improve. If features suggest giant cell arteritis or if symptoms persist or worsen, management should be reassessed, but the pattern described—rapid improvement within days and a taper over about 1–2 years—best fits the typical course of PMR.

In polymyalgia rheumatica, the inflammatory process responds quickly to glucocorticoids, so relief of proximal girdle pain and stiffness typically occurs within days of starting treatment. Because the goal is to control inflammation while minimizing steroid exposure, the usual plan is to taper over a prolonged period, commonly 1–2 years, rather than stopping abruptly or using high-dose steroids indefinitely. This approach balances effective symptom control with reducing long-term steroid risks.

Starting doses are modest (often around 15–20 mg of prednisone daily) and then tapered as symptoms and inflammatory markers improve. If features suggest giant cell arteritis or if symptoms persist or worsen, management should be reassessed, but the pattern described—rapid improvement within days and a taper over about 1–2 years—best fits the typical course of PMR.