Overview
Polymyalgia rheumatica (PMR) has an incidence of approximately 1000/10^6 for persons more than 50 years. Treatment with prednisolone carries several significant adverse effects, and it is therefore essential to taper prednisolone as fast as possible. Systematic treatment strategies (treat-to-target) is the most important improvement of disease management for other rheumatic diseases such as rheumatoid arthritis in the last decades. Thus, the purpose is to investigate benefits and harms associated with a nurce led systematic prednisolone taper strategy at the department of rheumatology compared to individual treatment by discretion of the general practitioner. It is a 1-year open label randomised trial with a 1-year extension in 120 treatment naïve patients with PMR.
Eligibility
Inclusion Criteria:
- Patients newly diagnosed with PMR according to the EULAR criteria for PMR.
- No sign of GCA on ultrasonography of the temporal and axillary arteries.
- Age over 50 years.
- Danish spoken and written language skills sufficient to fill out questionnaires.
Exclusion Criteria:
- Peroral, intraarticular or intramuscular application of glucocorticoids within the last month.
- Previous prednisolone treatment for GCA/PMR.
- Unable to give consent.
- Symptoms of GCA (newly onset-headache, tenderness of the temporal artery, jaw claudication, vision disturbances).
- Active malignant cancers within the last 5 years (except basal cell carcinoma).
- Other inflammatory rheumatic diseases (eg. rheumatoid arthritis, polymyositis, spondyloarthritis, psoriatic arthritits, gout).
- Uncontrolled diseases (eg severe active asthma, cardiac disease with NYHA class IV)