2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative.

Abstract

Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the management of PMR. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology as a framework for the project. Accordingly, the direction and strength of the recommendations are based on the quality of evidence, the balance between desirable and undesirable effects, patients' and clinicians' values and preferences, and resource use. Eight overarching principles and nine specific recommendations were developed covering several aspects of PMR, including basic and follow-up investigations of patients under treatment, risk factor assessment, medical access for patients and specialist referral, treatment strategies such as initial glucocorticoid (GC) doses and subsequent tapering regimens, use of intramuscular GCs and disease modifying anti-rheumatic drugs (DMARDs), as well as the roles of non-steroidal anti-rheumatic drugs and non-pharmacological interventions. These recommendations will inform primary, secondary and tertiary care physicians about an international consensus on the management of PMR. These recommendations should serve to inform clinicians about best practices in the care of patients with PMR.

• Authors: Christian Dejaco, Yogesh P Singh, Pablo Perel, Andrew Hutchings, Dario Camellino, Sarah Mackie, Andy Abril, Artur Bachta, Peter Balint, Kevin Barraclough, Lina Bianconi, Frank Buttgereit, Steven Carsons, Daniel Ching, Maria Cid, Marco Cimmino, Andreas Diamantopoulos, William Docken, Christina Duftner, Billy Fashanu, Kate Gilbert, Pamela Hildreth, Jane Hollywood, David Jayne, Manuella Lima, Ajesh Maharaj, Christian Mallen, Victor Martinez-Taboada, Mehrdad Maz, Steven Merry, Jean Miller, Shunsuke Mori, Lorna Neill, Elisabeth Nordborg, Jennifer Nott, Hannah Padbury, Colin Pease, Carlo Salvarani, Michael Schirmer, Wolfgang Schmidt, Robert Spiera, David Tronnier, Alexandre Wagner, Madeline Whitlock, Eric L Matteson, Bhaskar Dasgupta, European League Against Rheumatism, American College of Rheumatology
• Journal: Annals of the rheumatic diseases (Ann Rheum Dis) Vol. 74 Issue 10 Pg. 1799-807 (Oct 2015) ISSN: 1468-2060 [Electronic] England
• PMID: 26359488 (Publication Type: Journal Article, Practice Guideline, Research Support, Non-U.S. Gov't)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Chemical References

• Antirheumatic Agents
• Glucocorticoids

Topics

• Algorithms
• Antirheumatic Agents (therapeutic use)
• Biomedical Research (methods)
• Disease Management
• Drug Administration Schedule
• Evidence-Based Medicine (methods)
• Glucocorticoids (administration & dosage, therapeutic use)
• Humans
• International Cooperation
• Phytotherapy (methods)
• Polymyalgia Rheumatica (diagnosis, drug therapy)