What is the first-line treatment for Polymyalgia rheumatica?

Polymyalgia rheumatica is primarily characterized by muscle pain and stiffness, especially in the shoulders and hips, and is often associated with elevated inflammatory markers. The first-line treatment recommended is low-dose corticosteroids. This is because low-dose steroids effectively reduce inflammation and alleviate symptoms quickly, often leading to significant improvement in patients' quality of life.

Low-dose corticosteroids are preferred as they have a favorable side effect profile when used for this condition, especially since polymyalgia rheumatica tends to respond well to corticosteroids. Starting treatment at a low dose also helps minimize the risk of potential complications associated with higher doses or long-term steroid use, while still managing symptoms effectively.

Other classes of medications, such as immunosuppressants, are typically not used as initial treatments for this condition due to their different mechanisms of action and longer onset times, which may not provide the immediate relief that patients seek. Similarly, non-steroidal anti-inflammatory drugs (NSAIDs) can be used for symptomatic relief but are not as effective as corticosteroids in treating the underlying inflammatory process in polymyalgia rheumatica. High-dose steroids might be considered in more severe or refractory cases but are not the standard initial approach due to the potential for more severe side effects