This recently published study contends that the widespread use of corticosteroids early on in the course of PMR has prevented researchers from seeing the natural evolution of the disease. In fact this researcher found that in 73/95 patients (77%), a definitive diagnosis of RA could be made on average 8.5 months from PMR disease onset and "true PMR" was infrequent in the absence of GCA.
Moreover, when 68 of the RA patients (originally diagnosed with PMR) where treated with the anti-rheumatic medicine Hydroxychloroquine (HCQ) 58/68 (85%) responded dramatically. For these 58, an average interval of 13.5 months elapsed from disease onset to remission, which is far shorter than the 24-month expectation for PMR to spontaneously abate.
I assume this suggests there may be 2 different forms of PMR, or alternately 2 different forms of seronegative RA
Just when we thought we had heard it all……………