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Polymyalgia rheumatica - Management
Additional information
- A suggested monitoring schedule is to see the person at 3 and 6 weeks, and then at 3, 6, 9, and 12 months. After the first year, see the person every 3–6 months (with extra visits for relapses or adverse events).
- At each visit:
- Assess symptoms and review results of inflammatory markers (erythrocyte sedimentation rate [ESR] and/or C-reactive protein [CRP]).
- In the absence of symptoms, raised inflammatory markers alone are not a valid reason to increase the dose of corticosteroid.
- If inflammatory markers are raised and the person is scheduled to have their dose reduced, consider rechecking the inflammatory markers before deciding to reduce the dose.
- If inflammatory markers are persistently elevated, consider other possible diagnoses (such as malignancy, multiple myeloma, infection, or connective tissue disease).
- If inflammatory markers decrease but the person continues to complain of symptoms, consider other possible causes of the symptoms.
- Assess for adverse effects related to steroids (such as weight gain, raised blood pressure, diabetes, osteoporosis, and abnormal lipid profile).
- For more information on how to monitor the adverse effects of long-term corticosteroids, see the CKS topic Corticosteroids - oral.
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