Polymyalgia Rheumatica and Giant Cell Arteritis - Treatment Overview
gradually lowers the amount of medicine you take. How quickly he or she does
this varies with the individual.
- In polymyalgia rheumatica, most people have to take corticosteroids for about 2
- In giant cell arteritis, most people
have to take corticosteroids for 1 to 2 years, although many
people with the condition need them for longer than 2 years.
If your symptoms do not improve with corticosteroid
medicine, your doctor may need to test you for
other conditions that are similar to polymyalgia rheumatica or giant cell
Your doctor will track your condition while you are
taking corticosteroid medicine and for 6 to 12 months after you stop taking the
medicine. This tracking may include regular appointments or telephone calls to
discuss your symptoms and tests to measure your
erythrocyte sedimentation rate (ESR) or your
C-reactive protein (CRP) value.
table comparing corticosteroid treatment of polymyalgia rheumatica and giant cell arteritis.
If you need long-term
corticosteroid treatment for either condition, you are at risk for bone
thinning (osteoporosis). This is because corticosteroids
decrease how well your body takes in calcium, which is important in building
strong bones. Your doctor may recommend a bone density (DEXA) test to
see if you need medicine (bisphosphonates) to prevent osteoporosis. Or he or
she may simply start you on bisphosphonates without the test. For more
information, see the topic
Treatment if the conditions get worse
polymyalgia rheumatica (PMR) and
giant cell arteritis (GCA), your symptoms may return
(relapse) after a period of improvement. This often
occurs in the first 2 years of treatment or during the first 12 months
after you stop taking corticosteroid medicine. A relapse usually occurs if the
dose of corticosteroids is reduced or withdrawn too quickly. But up to 50% of
people with either condition have a relapse over the first 2 years that is not
related to how corticosteroids are used.2 If you have
a relapse of symptoms, your doctor will increase the corticosteroid dosage for
a period of time, then gradually decrease it after your symptoms are
See a table
comparing corticosteroid treatment of polymyalgia rheumatica and giant cell arteritis.
In rare cases, giant cell
arteritis can affect the main part of the
aorta in the chest, rather than one of its smaller
branches, causing an
aortic aneurysm. If this were to happen, you would
feel severe chest pain that could extend to your back, and you could faint or
have symptoms of a
stroke. If you have giant cell arteritis and have such
symptoms, contact your doctor or call911immediately. Though rare,
such an event may be life-threatening. Your doctor may recommend that you have
an annual chest X-ray to watch for an aortic aneurysm.