Corticosteroid medicine is the most common treatment for both polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). People with either or both conditions usually have fast relief of their symptoms soon after starting corticosteroid treatment.

Initial treatment

Corticosteroid medicine treats both polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). Generally, you will use the corticosteroids at a certain dose until your symptoms go away and your lab tests are normal. When this occurs, your doctor will gradually begin reducing your medicine.

For polymyalgia rheumatica:

• You take lower doses of corticosteroids than in giant cell arteritis, generally 5mg to 20mg per day.²
• You are likely to have a lot of pain relief in a few days, and symptoms usually go away and your lab results are normal in 2 to 3 weeks. If your symptoms don't start going away within 2 to 4 days, your doctor may give you a higher dose (possibly 30mg daily) and do further testing to be sure your condition is polymyalgia rheumatica.
• After your symptoms go away and your laboratory tests are normal, your doctor will gradually lower your dose, generally every few weeks.
• You will probably have to take corticosteroids for about 2 years or more to prevent the symptoms from returning (relapse). Some people only need to take the medicine for less than a year.

For giant cell arteritis:

• You take higher doses of corticosteroids than used in polymyalgia rheumatica, generally 40mg to 60mg per day.² Because giant cell arteritis can cause serious complications, such as stroke or blindness, your doctor may start treatment immediately, even if the diagnosis has not been confirmed by tests.
• You are likely to have a lot of pain relief in a few days, and symptoms usually go away and your lab results are normal in 2 to 4 weeks. If your symptoms don't start to go away, your doctor may give you a higher dose.
• After your symptoms go away and your lab tests are normal, your doctor will gradually lower your dose, generally every 2 to 4 weeks in the first several months, then less often after that.
• You will probably have to take corticosteroids for 1 to 2 years to prevent relapse, although about half of the people with the condition need them for longer than 2 years.³

See a table comparing corticosteroid treatment of polymyalgia rheumatica and giant cell arteritis.

How long you need to take corticosteroids depends on how severe your condition is, whether it appears cured or not (remission), and how often you have relapses. Some people are not able to completely stop taking corticosteroids over time. If this happens, your doctor may suggest another medicine such as methotrexate to help control your symptoms and keep the condition from coming back.

Ongoing treatment