Recommendations of the French Society of Rheumatology for the management in current practice of patients with polymyalgia rheumatica - 11/07/24
, Omar Al Tabaa b, c, 1, Baptiste Chevet d, 1, Olivier Fakih a, 1, Roba Ghossan b, 1, Sophie Hecquet b, 1, Emmanuelle Dernis e, Emmanuel Maheu f, Alain Saraux d, Florent L. Besson g, Guillermo Carvajal Alegria h, Bernard Cortet i, Bruno Fautrel j, Renaud Felten k, Jacques Morel l, Sébastien Ottaviani m, Solène Querellou-Lefranc n, André Ramon o, Adeline Ruyssen-Witrand p, Raphaèle Seror q, Anne Tournadre r, Nathan Foulquier s, Bernard Verlhac t, Frank Verhoeven a, Valérie Devauchelle-Pensec d, ⁎ Highlights |
• | These are the first recommendations of the French Society of Rheumatology about management of PMR. |
• | They include the initial work-up: differential diagnosis, imaging, and evaluation of comorbidities. |
• | Non-pharmacological means are essential along the disease. |
• | Corticosteroids remain the cornerstone of pharmacological treatment, with a dosage as low as possible (initial dosing 0.2–0.3 mg/kg/day). |
• | Regular follow-up and corticosteroid tapering over 12 months are recommended. |
• | Corticosteroid-sparing agents (anti IL-6R) should be considered in case of corticodependance. |
Abstract |
Objective |
To develop recommendations for the routine management of patients with polymyalgia rheumatica (PMR).
Methods |
Following standard procedures, a systematic review of the literature by five supervised junior rheumatologists, based on the questions selected by the steering committee (5 senior rheumatologists), was used as the basis for working meetings, followed by a one-day plenary meeting with the working group (15 members), leading to the development of the wording and determination of the strength of the recommendations and the level of agreement of the experts.
Results |
Five general principles and 19 recommendations were drawn up. Three recommendations relate to diagnosis and the use of imaging, and five to the assessment of the disease, its activity and comorbidities. Non-pharmacological therapies are the subject of one recommendation. Three recommendations concern initial treatment based on general corticosteroid therapy, five concern the reduction of corticosteroid therapy and follow-up, and two concern corticosteroid dependence and steroid-sparing treatments (anti-IL-6).
Conclusion |
These recommendations take account of current data on PMR, with the aim of reducing exposure to corticosteroid therapy and its side effects in a fragile population. They are intended to be practical, to help practitioners in the day-to-day management of patients with PMR.
Le texte complet de cet article est disponible en PDF.Keywords : Polymyalgia rheumatica, Assessment, Imaging, Treatment, General corticosteroid therapy, Anti-IL-6, Recommendations
Plan
Vol 91 - N° 4
Article 105730- juillet 2024 Retour au numéro
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