[Polymyalgia rheumatica and temporal arteritis. Observations on prognosis and treatment]

1. There is still controversy about polymyalgia rheumatica (PMR) and temporal arteritis (TA), either expressions of a single disease or two different conditions with overlapping. Nearly 50% of TA present with a PMR syndrome and 5% of PMR have a positive temporal artery biopsy. 2. Biopsy is useful for diagnostic purposes but does not seem to have any prognostic value in the management of PMR and TA. 3. The best symptomatic treatment is represented by prednisone. Prednisone has to be continued over a large period of time creating adverse effects in elderly people unless minimal doses are used. 4. TA visual or neurological complications are often observed in the first weeks of the disease thus leading many authors to recommend high doses (0.5 mg to 1 mg/kg/day) to patients with TA and even with PMR. To us starting high doses are to be used in severe clinical conditions of TA, particularly those presenting visual symptoms (nevertheless lower doses may be successful as well). Concerning other patients with TA and with PMR a starting dose of 10 to 30 mg depending on the clinical picture then a follow up dosage of 10 and even less, is suggested.