29th January 2024

Treatment

High-dose glucocorticoid therapy (prednisolone 40-60mg once a day) for 2-4 weeks is indicated for all newly diagnosed and recurrent disease. Most patients improve dramatically within 1-3 days. However, blindness is usually irreversible, which highlights the importance of early detection and treatment. Prednisolone is then tapered down to a maintenance dose to control the symptoms, generally up to 2 years. Rarely, steroid-sparing therapies such as methotrexate can be used in patients who do not respond, relapse or are at high risk of complications from long-term steroid therapy. PMR generally responds well to low-dose prednisolone.