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VBCR - October 2015, Volume 4, No 5 - Value Propositions

In September, the American College of Rheumatology (ACR) released new treatment guidelines for polymyalgia rheumatica (PMR). Developed in cooperation with the European League Against Rheumatism (EULAR), these guidelines are the first international recommendations for the screening, treatment, and management of PMR, a disease often met with significant variations in clinical care.

PMR affects almost 711,000 elderly Americans. The pain and stiffness caused by PMR can impact many areas of a patient’s life, yet PMR is sometimes difficult to diagnose because it seldom causes signs that can be detected during physical exams. Often, effective management of PMR calls for the rheumatologist to work with other healthcare professionals. According to Eric Matteson, MD, coprimary investigator for the new recommendations, the guidelines will offer “primary, secondary, and tertiary care physicians...an international consensus on the management of PMR.” Matteson also noted that the guidelines have “a particular emphasis on patients’ perspectives.”

Recommendations for which there is extensive evidence of benefit with little or no risk are identified as “strong.” Those for which there is less evidence of benefit and/or benefits did not greatly outweigh risks are labeled “conditional.” The first 6 of the panel’s specific recommendations address glucocorticoid (GC) therapy. The panel strongly recommends using GCs rather than nonsteroidal anti-inflammatory drugs in treating PMR patients and makes dosage and tapering recommendations. Also addressed are the use of methotrexate, intramuscular methylprednisone as an alternative to oral GCs, and nonpharmacological therapies.

The recommendations of the ACR and EULAR panel should describe best practices for clinicians and lead to more efficient, effective care of patients with PMR. American College of Rheumatology. Press release. September 10, 2015.

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Last modified: October 29, 2015
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