At what point do you consider a patient to have relapsing PMR?  

Relapses in PMR are quite common. It is not unusual for patients to do well initially and as steroids are tapered, they start to describe a recurrence of symptoms. My concern is when these relapses occur early. For example, if they are noted as a patient tapers down from 10 mg towards 5 mg/day and r...

I would be very cautious calling PMR relapse without the rise of ESR/CRP. More likely, the patient is feeling the pain of OA return with steroid taper IMO. Remember, Pred treats all pain non-inflammatory arthritis, and inflammatory arthritis. If the patient has even a small bump with classic PMR, it...

My approach is similar to Dr. @Helfgott's with some additional insights. I often advise patients on prednisone alone, without an anti-IL6 drug (which I believe can shorten PMR's clinical course), that the speed of their corticosteroid tapering is largely predetermined. Our job is to figure out how f...

I would define a clinical relapse as recurrent signs/symptoms of PMR once remission has been achieved. A supporting rise in inflammatory markers is helpful but not necessary to define relapse; similarly, improvement of symptoms with increased glucocorticoid dose also suggests a relapse. There is no ...