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Polymyalgia Rheumatica and Giant Cell Arteritis - Treatment Overview

Ongoing treatment continued...

Your doctor gradually lowers the amount of medicine you take. How quickly he or she does this varies with each person.

  • In polymyalgia rheumatica, most people have to take corticosteroids for about 2 years.
  • In giant cell arteritis, most people have to take corticosteroids for 1 to 2 years. But many people with the condition need them for longer than 2 years.

If your symptoms do not improve with corticosteroid medicine, your doctor may need to test you for other conditions that are similar to polymyalgia rheumatica or giant cell arteritis.

Your doctor will track your condition while you are taking corticosteroid medicine and for 6 to 12 months after you stop taking the medicine. This may include regular appointments or phone calls to discuss your symptoms. And you may need tests to measure your erythrocyte sedimentation rate (ESR) or your C-reactive protein (CRP) value.

If you need long-term corticosteroid treatment for either condition, you are at risk for bone thinning (osteoporosis). This is because corticosteroids reduce how well your body takes in calcium, which is important in building strong bones. Your doctor may recommend a bone density (DXA) test to see if you need medicine (bisphosphonates) to prevent osteoporosis. Or he or she may simply start you on bisphosphonates without the test. For more information, see the topic Osteoporosis.

Treatment if the conditions get worse

In both polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), your symptoms may come back (relapse) after a period of improvement. This often occurs in the first 2 years of treatment or during the first 12 months after you stop taking corticosteroid medicine. A relapse usually occurs if the dose of corticosteroids is reduced or withdrawn too quickly. But sometimes people have a relapse over the first 2 years that is not related to how corticosteroids are used. If you have a relapse of symptoms, your doctor will increase the corticosteroid dosage for a period of time then gradually decrease it after your symptoms are gone.

In rare cases, giant cell arteritis can affect the main part of the aorta in the chest, rather than one of its smaller branches, causing an aortic aneurysm. If this were to happen, you would feel severe chest pain that could extend to your back, and you could faint or have symptoms of a stroke. If you have giant cell arteritis and have such symptoms, contact your doctor or call911immediately. Though rare, such an event may be life-threatening. Your doctor may recommend that you have an annual chest X-ray to watch for an aortic aneurysm.

Giant cell arteritis can lead to partial or complete loss of vision in one or both eyes. If you have sudden onset of double, blurred, or "browned-out" vision, or temporary loss of vision, your doctor may increase your corticosteroid dose. And for a few days he or she may give you the dose directly into a blood vessel (intravenously) to try to prevent permanent or further loss of vision.

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WebMD Medical Reference from Healthwise

Last Updated: April 10, 2013
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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