What is the first-line medication for treating polymyalgia rheumatica?

Polymyalgia rheumatica is primarily characterized by muscle pain and stiffness, particularly in the shoulders, hips, and neck. The condition often responds dramatically to corticosteroids, and prednisone is particularly effective in alleviating the symptoms.

The use of prednisone as a first-line treatment is based on its anti-inflammatory properties, which provide rapid relief of symptoms and help restore function. Many patients experience significant improvement within days of starting corticosteroid therapy. The dosage may be adjusted based on individual responses and the severity of the condition, but starting with prednisone is standard practice.

Other medications listed, such as methotrexate, hydroxychloroquine, and NSAIDs, may have roles in managing associated conditions or in specific cases of inflammatory arthritis but are not the first line for polymyalgia rheumatica due to the less immediate and effective symptom relief they offer compared to corticosteroids. Methotrexate and hydroxychloroquine are typically used in chronic inflammatory conditions like rheumatoid arthritis, while NSAIDs may help with pain relief but do not address the underlying inflammation in the same effective manner as corticosteroids.