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

Dejaco, Christian; Singh, Yogesh P; Perel, Pablo; Hutchings, Andrew; Camellino, Dario; Mackie, Sarah; Abril, Andy; Bachta, Artur; Balint, Peter; Barraclough, Kevin; Bianconi, Lina; Buttgereit, Frank; Carsons, Steven; Ching, Daniel; Cid, Maria; Cimmino, Marco; Diamantopoulos, Andreas; Docken, William; Duftner, Christina; Fashanu, Billy; Gilbert, Kate; Hildreth, Pamela; Hollywood, Jane; Jayne, David; Lima, Manuella; Maharaj, Ajesh; Mallen, Christian; Martinez-Taboada, Victor; Maz, Mehrdad; Merry, Steven; Miller, Jean; Mori, Shunsuke; Neill, Lorna; Nordborg, Elisabeth; Nott, Jennifer; Padbury, Hannah; Pease, Colin; Salvarani, Carlo; Schirmer, Michael; Schmidt, Wolfgang; Spiera, Robert; Tronnier, David; Wagner, Alexandre; Whitlock, Madeline; Matteson, Eric L; Dasgupta, Bhaskar

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

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



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.

Acceptance Date Jul 13, 2015
Online Publication Date Sep 9, 2015
Publication Date Oct 1, 2015
Journal Annals of the Rheumatic Diseases
Print ISSN 0003-4967
Publisher BMJ Publishing Group
Volume 74
Issue 10
Pages 1799 - 1807
DOI https://doi.org/10.1136/annrheumdis-2015-207492
Publisher URL https://ard.bmj.com/content/74/10/1799

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