British Society of Rheumatology Guidelines

The BSR guidelines for PMR and GCA are currently up for review and updating, and an international group is also working on a project to establish a set of globally shared guidelines for PMR. However, it's a while since we pointed you in the direction of the guidelines that are currently in operation. These are written for the benefit not only of rheumies but also GPs. We don't think they are perfect, a) because knowledge is partial and b) because these conditions vary so much from person to person. But they are a good place to start if you need to get more knowledge before discussing your condition and treatment with a doctor.

Take care of yourselves!


5 Replies

Hi Kate,

I am rather confused by your latest posting regarding the management of PMR - having just read a new post by Sambuca from our North East branch.

The article posted was writen by Prof. John Kirwan and dated 2013. It suggests a completely new line of treatment management for PMR - 6 weeks on 15mg, then 6 weeks on 12.5mg and then one year on 10mg followed by a monthly reduction of one mg. I think I have this right. He says, how ever, that sometimes there may be a flare in the first 6 to 18 months of treatment, but does not say what the procedure is if that happens.

He also says that most patients make a full recovery with little or no side effects from the prednisolone.

I guess this article may have been condensed somewhat, but I can't help but wish that my illness had been handled this way - My adrenals might be more inclined to wake up again.



Hi Pats. The article in the NE newsletter describes the method followed by Prof. Kirwan in his clinic in Bristol. His regime is a little different to what is in the current BSR guidelines. As you might imagine, there is some controversy about what is the best way of reducing steroids over time, and this question will be tackled in the project to develop the new guidelines. We'll be running an article on it in the next PMRGCAuk newsletter.


Hi Kate.I seem to be at a loss here as I do not know the guide line for the treatment of PMR except what my doctor told me when I was diagnose nearly three years ago. I had, had the illness 4yrs then and didn't know. I was started on 15mg and told to reduce to ten three weeks later. Since then I have gone up and gone down without feeling any better. I have pain mostly in my right thigh and left shoulder but I also suffer from Sciatica in my right leg too which I have suffered from since 1964 due to a back injury and also arthritis in my right hip and ankle so it makes it difficult to work out what and where the pain is coming from. My question is where can I get current information and news letters?cynbil


I found this very reassuring - my consultant suggested, and I have followed, these dose reduction outlines, and so far (touch wood!) I'm down to 9mg and doing well. The original print-out I was given suggested I might be on steroids for up to 3 years, which I did worry me a bit. So far, no major side-effects, apart from loss of "get up and go", but I think this may be the PMR rather than the steroids.

Any suggestions for getting it back - or dosage at which I might expect to feel a bit more like my old self?


Hi Kate I have had GCA for 17 months. I have never seen a rheumy is it worth me asking my GP for an appt please?


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