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Printable Handouts
Navigable Slide Index
- Introduction
- Disclosures
- Evidence-based medicine
- Areas covered
- Pathophysiology PMR
- Polymyalgia rheumatica: Th1 and Th17 cells
- Expression of IL-6 in synovial tissue with PMR
- PMR, GCA and Large vessel vasculitis
- Guidelines for the management of PMR
- Approach to polymyalgia
- Step-wise approach to PMR
- Steroid response in PMR and Pitfalls
- 2012 EULAR ACR classification criteria
- PMR: Shoulder MRI and sonography
- Scoring algorithm without ultrasound
- Indications for imaging in PMR
- Ultrasound imaging in suspected PMR
- Relapsing PMR
- Shoulder ultrasound findings in RA
- 77 years male with polymyalgia & RS3PE
- MRI polymyalgic RS3PE
- Bursitis/enthesitis in PMR FDG-PET CT
- PMR and late onset spondyloarthritis
- Polymyalgia arteritica (1)
- Polymyalgia arteritica (2)
- Assessment of disease: PMR
- Minimum data at diagnosis – baseline (1)
- Minimum data at diagnosis – baseline (2)
- Disease activity assessment – baseline
- Laboratory markers – baseline
- PMR monitoring data collection – every visit
- Disability/exam/labs at every visit
- Imaging (ultrasound or MRI) baseline, 24 weeks
- 2015 EULAR ACR PMR recommendations (1)
- 2015 EULAR ACR PMR recommendations (2)
- Over-arching principles of care safe & specific approach
- Over-arching principles: Safe and specific approach to PMR
- Early specialist referral: Non-PMR clues
- Minimum dataset prior to Rx
- Individual recommendations NSAIDs
- Individual recommendations: Glucocorticoid dose & duration
- Individual recommendations: Glucocorticoid dose tapering
- Mean daily steroid dose (mg) since previous assessment
- Cumulative steroid dose (mg) at each assessment
- Adverse events
- Glucocorticoid doses: Benefits versus side effects
- Glucocorticoid doses (1)
- Glucocorticoid doses (2)
- I.M. steroids as an alternative in PMR
- Depot methylprednisolone vs. prednisolone cumulative steroid dosage
- Fractures
- Steroids or bust?
- Relapse-free survival
- The alternative
- Response to glucocorticoids in PMR
- Individual recommendations – methotrexate
- Leflunomide in PMR
- Individual recommendations Biologic agents
- IL-6 blockade RCT in PMR
- Other targeted therapies in PMR
Topics Covered
- Pathophysiology and approach to PMR
- 2015 EULAR ACR and 2009 BSR recommendations
- Over-arching principles
- Early specialist referral
- Disability and QOL in PMR
- Assessment of PMR
- Glucocorticoids
- Steroids or bust?
- Methotrexate/leflunomide/biologics
- Role of exercise in PMR
Talk Citation
Dasgupta, B. (2023, February 28). Polymyalgia rheumatica: causes, symptoms, diagnosis, treatment, and outlook [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved October 8, 2024, from https://doi.org/10.69645/LESJ8726.Export Citation (RIS)
Publication History
Financial Disclosures
- Sponsorships: Novartis, Roche Chugai, Sanofi, Abbvie; Speaker’s fees: Roche Chugai, Cipla.
A selection of talks on Immunology
Transcript
Please wait while the transcript is being prepared...
0:00
It gives me great
pleasure to talk
to you about
polymyalgia rheumatica,
the causes of PMR symptoms,
the diagnosis,
treatment, and the
outlook of the condition.
0:18
Here are my disclosures.
0:21
This is the evidence
base for the talk.
Primarily, it includes
the BSR guidelines
on PMR published back in 2010.
The 2012 EULAR ACR
classification criteria
for PMR, published in 2012.
The patient-reported
outcomes in PMR.
The clinical outcomes,
quality of life
and diagnostic
uncertainty in PMR.
The PMR UK outcome study,
which was completed
back in 2006.
And of course the 2015 EULAR
ACR PMR recommendations.
I shall also cite
recent papers about
the pathophysiology
of PMR based
on the work that has come out
of Groningen in the Netherlands.
1:16
The areas that will be covered
in my talk: one, the
pathophysiology,
two, the approach
that we take to PMR
as well as the
polymyalgic syndrome.
We will talk in detail
about the 2015 EULAR ACR
and 2009 BSR recommendations.
We'll talk about the
overarching principles,
indications for early
specialist referral,
the role of disability and
quality of life in PMR.
How do we assess PMR?
How do we treat PMR
with glucocorticoids,
initial dosage and
glucocorticoid taper?
Whether there's a role for
disease-modifying agents
such as methotrexate,
leflunomide,
and the increasing scope
of biologics in PMR.
The role of lifestyle measures
such as exercise and, of course,
we will talk a little bit about
some of the clinical
trials that are going on.
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