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Here is a table summarizing the Corticosteroid therapy recommendations for the treatment of PMR by the Royal College of Physicians 2010
| Guideline | Regimen |
|---|---|
| Note | In the absence of GCA, urgent steroid therapy is not indicated before clinical evaluation is complete. |
| Suggested initial oral steroid and tapering regimen | |
| Prednisolone dosage for initial weeks | 15 mg daily for three weeks |
| 12.5 mg daily for three weeks | |
| 10 mg daily for four to six weeks | |
| Final reduction phase | Reduction by 1 mg every four to eight weeks |
| OR | |
| Alternate day reductions | 7.5 mg/10 mg alternate days |
| Response to treatment (indicative of PMR) | |
| Early rapid improvement in symptoms | 70% patient global response in 1 week—likely to be PMR |
| If less than 70% response | Consider increasing the dose up to 20mg prednisolone |
| If still less than 70% response after dose increment | Reconsider diagnosis and refer to rheumatology |
| Prevention of steroid-related osteoporosis | |
| Bone protection | Weekly bisphosphonate and calcium or vitamin D supplementation should be co-prescribed with glucocorticoid therapy |
References
1 management-of-polymyalgia-rheumatica-pmr-2022.pdf (scot.nhs.uk)
2 Diagnosis and management of PMR RCP June 2010
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