Polymyalgia Rheumatica Follow-up

Updated: Nov 16, 2017
  • Author: Ehab R Saad, MD, MA, FACP, FASN; Chief Editor: Herbert S Diamond, MD  more...
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Follow-up

Further Outpatient Care

Joint guidelines from the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) recommend regular monitoring that includes clinical assessment and laboratory studies, on the following schedule [22] :

  • Every 4-8 weeks in the first year of treatment
  • Every 8-12 weeks in the second year
  • As indicated, in case of relapse or as prednisone is tapered off
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Complications

PMR usually has a limited course of several months to 5 years. Untreated patients often feel unwell and have an impaired quality of life, but generally, PMR is not associated with serious complications. Patients treated with corticosteroids are at risk for long-term complications of corticosteroid therapy.

Relapses are common and may occur in up to 25% of all treated patients. Arteritic relapse in a patient who presented exclusively with PMR is unusual.

Every patient should be considered at risk for GCA.

Several cases of systemic amyloidosis – associated PMR have been reported.

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Prognosis

PMR is usually self-limited. With prompt diagnosis and adequate therapy, the condition has an excellent prognosis

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Patient Education

Inform the patient about the potential benefits and risks of corticosteroids treatment and encourage the patient to participate in choosing the treatment plan.

Emphasize the importance of healthy dietary habits and ensure adequate calcium and vitamin D supplementation.

Emphasize compliance with long-term treatment plans and follow-up care in order to prevent relapses, flares, and subsequent morbidity secondary to corticosteroid therapy.

Advise patients to immediately seek medical care if symptoms recur.

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