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Related Concept Videos

Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
261
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

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Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
153
Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

269
The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
269
Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

243
AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
243
Myocarditis IV: Nursing Management01:22

Myocarditis IV: Nursing Management

190
Myocarditis is an inflammatory condition of the myocardium requiring meticulous nursing management for optimal patient outcomes. Effective management begins with a thorough assessment of the patient's medical history, paying close attention to past infections, autoimmune disorders, travel history, and exposure to toxins or drugs. Recent viral infections and systemic diseases are particularly relevant due to their potential role in triggering myocarditis.Physical Examination and MonitoringThe...
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Tonsillitis II: Management01:26

Tonsillitis II: Management

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This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
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Prognostic value of quantifying vascular inflammation through ultrasound in patients with giant cell arteritis: the MAGiCUS study.

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Modern Management of Isolated Polymyalgia Rheumatica.

Patricia Harkins1,2, Sharon Cowley3, Eoghan Burke4

  • 1Department of Rheumatology, St. James Hospital, Dublin, Ireland. harkinp@tcd.ie.

Rheumatology and Therapy
|October 14, 2025
PubMed
Summary

Polymyalgia rheumatica (PMR) management needs improvement. New biologic therapies offer hope for refractory cases, but diagnostic and treatment gaps persist, requiring better pathways and monitoring.

Keywords:
BiologicGlucocorticoidsInterleukin-6Patient-reported outcomesPolymyalgia rheumatica

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Area of Science:

  • Rheumatology
  • Clinical Immunology
  • Internal Medicine

Background:

  • Polymyalgia rheumatica (PMR) is a common, clinically heterogeneous inflammatory disorder in individuals over 50.
  • Diagnostic challenges arise from the lack of a gold standard test and numerous disease mimics.
  • Glucocorticoids (GCs) are standard therapy but associated with significant adverse effects in this vulnerable population.

Purpose of the Study:

  • To review current diagnostic and treatment strategies for polymyalgia rheumatica.
  • To identify unmet needs in PMR management.
  • To discuss future directions for improving patient outcomes and care pathways.

Main Methods:

  • Review of current literature on polymyalgia rheumatica diagnosis and treatment.
  • Analysis of recent therapeutic advancements, including biologic agents.
  • Identification of gaps in current management protocols and guidelines.

Main Results:

  • Glucocorticoids remain the primary treatment, despite toxicity concerns.
  • The approval of sarilumab marks the first biologic therapy for refractory PMR.
  • Significant unmet needs include timely diagnosis, stratified treatment, and standardized monitoring.

Conclusions:

  • Advances in biologic therapies are transforming PMR treatment.
  • Improved diagnostic pathways, specialist evaluation, and structured monitoring are crucial.
  • Future research should focus on optimizing GC-sparing strategies and refining the PMR care pathway.