What are the 2012 ACR/EULAR provisional PMR criteria?

Score items: shoulder pain bilateral (2pts), hip pain or limited ROM (1pt), negative RF and ACPA (2pts), morning stiffness >45 min (1pt), acute phase reaction (CRP>normal and/or ESR>40mm/h: 1pt), rapid response to pred (1pt); ≥4/6 = PMR classification.

What prednisolone starting dose treats PMR?

Prednisolone 12.5-25 mg/day; dramatic response within 24-72h confirms diagnosis (therapeutic trial); slow taper: 12.5 mg for 3-4 weeks, then reduce by 1-2.5 mg/6-8 weeks; aim for 10 mg/day by 4-8 weeks; total treatment typically 1-2 years.

What distinguishes PMR from early RA?

PMR: age >50, symmetric shoulder/hip girdle stiffness, no small joint involvement, RF/ACPA negative, dramatic steroid response; early RA: symmetric small joint involvement, seropositivity, inadequate steroid response; ultrasound bursitis pattern differs.

What symptoms suggest underlying giant cell arteritis in PMR?

Temporal or occipital headache, scalp tenderness, jaw claudication, new visual symptoms, diplopia in patients with PMR should prompt urgent temporal artery biopsy; GCA coexists in 10-16% of PMR; pulse steroids (1 mg/kg) and immediate biopsy for visual symptoms.

What is the role of tocilizumab in PMR?

Tocilizumab (anti-IL-6R) studied for refractory/relapsing PMR; SEMAPHORE trial: significantly reduces relapse rate and cumulative prednisolone dose; approved in some countries for glucocorticoid-sparing in PMR; IL-6 pathway is central to PMR pathogenesis.

Polymyalgia Rheumatica (PMR) 2012 ACR/EULAR Classification Criteria

Calculates 2012 ACR/EULAR provisional classification criteria score for polymyalgia rheumatica, CRP/ESR flare frequency, and steroid tapering schedule with GCA vigilance assessment.

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Polymyalgia Rheumatica (PMR) 2012 ACR/EULAR Classification Criteria

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Frequently Asked Questions

What are the 2012 ACR/EULAR provisional PMR criteria?

What prednisolone starting dose treats PMR?

What distinguishes PMR from early RA?

What symptoms suggest underlying giant cell arteritis in PMR?

What is the role of tocilizumab in PMR?