Vasculitis & polymyalgia rheumatica
2025 EULAR recommendations for the management of polymyalgia rheumatica and primary large vessel vasculitis
Methodological detailsEULAR recommendations, systematic literature reviews, international task force, structured voting process, Update of EULAR recommendations for polymyalgia rheumatica (PMR) (2015) and giant cell arteritis (GCA)/TAK (2018); 4 overarching principles, 12 recommendations and 2 quality indicators agreed, all with high levels of agreement
- EULAR recommendations
- Systematic literature reviews
- International task force
- Structured voting process
- Update of EULAR recommendations for PMR (2015) and GCA/TAK (2018); 4 overarching principles, 12 recommendations and 2 quality indicators agreed, all with high levels of agreement
Recommendations
As issued by the authors
Refer all patients with suspected PMR, GCA or TAK for specialist assessment; suspected GCA within 24 hours
Strong clinical suspicion of GCA: start GC without delay, while awaiting confirmatory investigations
Most patients with suspected PMR or TAK: GC can be delayed until diagnosis is confirmed
Remission induction: GC 15 to 25 mg/day prednisone-equivalent for PMR and 40 to 60 mg for GCA or TAK
Guidance on GC tapering is provided
Adjunctive therapy for selected patients with PMR or GCA: IL-6R inhibitors for PMR and GCA, or upadacitinib for GCA; MTX may be an alternative
GC-sparing agents in combination with GC for all patients with TAK
Original publication
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