What Are the Most Recent Treatment Guidelines for PMR, and What Are the Key Clinical Takeaways?

July 2025

In this video, Kyle George, PA-C, a rheumatology physician assistant with St. Luke’s Rheumatology in Idaho, reviews the key clinical takeaways from the 2015 ACR and EULAR treatment guidelines for polymyalgia rheumatica (PMR). PMR is a common inflammatory condition in older adults, marked by bilateral shoulder or hip girdle pain and stiffness. Kyle discusses the diagnostic criteria, the hallmark rapid response to low-dose glucocorticoids, and the importance of screening for concurrent giant cell arteritis (GCA). He breaks down recommended prednisone tapering strategies, the definition and management of disease flares, and the conditional use of methotrexate for patients with frequent relapses or steroid intolerance. The video also explores the emerging role of biologics, including the 2023 FDA approval of sarilumab, an IL-6 receptor inhibitor, for moderate to severe PMR. As treatment options evolve, understanding both the foundation of existing guidelines and new advances is critical to optimizing care. For more PMR-focused education, visit RhAPP.org.