title: Update on polymyalgia rheumatica.
abstract: Polymyalgia rheumatica is an inflammatory disease of unknown etiology affecting individuals aged fifty years and older, mainly of Caucasian ethnicity. Polymyalgia rheumatica is associated with giant cell arteritis more frequently than expected by chance alone. In both conditions, females are affected two to three times more often than males. The clinical hallmark manifestations of polymyalgia rheumatica are aching and morning stiffness in the shoulder girdle and often in the pelvic girdle and neck. Serum inflammatory markers are typically elevated, while the most consistent abnormal finding on imaging studies is bursitis in the symptomatic areas. A dramatic response to glucocorticoids is characteristic of polymyalgia rheumatica. Many patients are able to discontinue glucocorticoids six months to two years after the onset of clinical symptoms, but some patients may require longstanding glucocorticoid treatment. Glucocorticoid-sparing agents may be helpful in patients with chronic relapsing courses and those at high risk of glucocorticoid-related adverse events.
authors.affiliation: Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy.
authors.forename: Nicolò
authors.initials: N
authors.lastname: Pipitone
authors.forename: Carlo
authors.initials: C
authors.lastname: Salvarani
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D011111:Polymyalgia Rheumatica / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D055502:Secondary Prevention
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids
keywords: Bursitis; Elderly; Glucocorticoids; Polymyalgia rheumatica; TNF-α inhibitors; Tocilizumab