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Answers tagged polymyalgia rheumatica: Page 1 of 1
Stella from Medicine Hat asks: Can you use Tocilizumab (Actemra) for Giant Cell Arteritis?
Giant Cell Arteritis (GCA) is a form of autoimmune vasculitis (inflammation of blood vessels) that affects large blood vessels in the body, but most commonly arteries in the head area, particularly around the temples. Among other symptoms, it can cause headaches, scalp tenderness, and difficulty chewing your food. Some individuals may also have pain around their shoulders or hips. If not treated, GCA can cause sudden vision problems which in some cases, can be irreversible. This makes quick recognition and treatment of GCA important. GCA is most often first treated with prednisone. For some patients, if they are having difficulty getting off Prednisone, other disease modifying agents may be used. One of the newest treatment options for GCA is tocilizumab (Actemra). While some rheumatologists will use it at the start of treatment with Prednisone, others may wait to see if it is needed depending on how beneficial the Prednisone was. In individual cases, there may be reasons to use it earlier or later.
Kim from the United States asks: Many years ago, I was diagnosed with polymyalgia rheumatica when I could not turn over in bed and my ESR was elevated. I was treated for many years with what ended up being 5 mg of prednisone per day. Several attempts to quit taking it failed and my rheumatologist said that some patients have to take it for years. I moved two years ago and my new rheumatologist made me stop taking prednisone because I no longer had an elevated ESR. This has really affected my health and I live in pain without it. I have been off prednisone for about six months and my life quality is greatly reduced. I am otherwise pretty healthy with no heart disease or diabetes. I don’t understand why this is such a big deal to my doctor. Do you have any advice for me?
In general, the risks of prednisone are significant, as you can read here. Those risks increase with higher dose of prednisone, but also for how long someone takes prednisone. Of course, the balance is the quality of life prednisone, or any treatment, can provide. While PMR classically presents with proximal muscle pain around the hips and shoulders associated with an elevated ESR, this does not need to be the case. In situations like these, which apply to PMR but many rheumatic diseases, speaking to your rheumatologist so you are both on the same page is worthwhile. Does your rheumatologist believe there is a different cause for pain now and if so, discuss a new treatment approach that will be effective for this pain? If it is still PMR, can your rheumatologist discuss other options that are available that may be effective at treating PMR but without the need for prednisone? These can be common situations and often the opportunity for clear communication helps so everyone is on the same page.
Wendy from the UK asks: Does the treatment of Polymyalgia Rheumatica with steroids prevent Giant Cell Arteritis?
Polymyalgia rheumatica (PMR) and giant cell arteritis, otherwise known as GCA or temporal arteritis, are distinct condition that may present at the same time. Many patients with GCA also will present with PMR, while a smaller proportion of patients with PMR present with GCA. While the treatment for both starts the same – glucocorticoids – the doses are very different. PMR is treated with low dose prednisone, while GCA initially requires high dose prednisone. That said, once on prednisone, the risk of developing GCA, and particularly loss of vision from GCA, drops significantly.
Gwen from Edmonton asks: I was diagnosed with fibromyalgia rheumatica 4 years ago….took prednisone ….tapered very slowly off this summer…….now all the symptoms are back…..how long does this disease last?
It is common to confuse fibromyalgia and polymyalgia rheumatica (PMR) – the first is a condition associated with chronic pain and can be treated with a number of non-pharmacologic options, while PMR requires low dose prednisone for approximately one year. In most cases of PMR, a slow titrating course of prednisone is effective, although there are times when symptoms return. For these cases, retreatment with prednisone, or the addition of steroid sparing medications, is considered. Equally important is to review your symptoms with your physician to ensure the correct diagnosis, or change in diagnosis.