Steroid sparing therapeutic approaches to polymyalgia rheumatica-giant cell arteritis. State of the art and perspectives.

The therapeutic approach to polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) remains mainly based on corticosteroids. A few studies in PMR suggest a steroid-sparing effect with methotrexate in a subset of patients. No real alternative to steroids exists in GCA. Given the high chance of long-term treatment with corticosteroids in both diseases, randomized controlled trials with new immunosuppressive steroid-sparing drugs are eagerly awaited.