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Temporalarteritt: Behandling

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AT behandles med innleggelse i sykehus. Prednisolon brukes for å dempe betennelsen. 

Ofte ses en dramatisk forbedring av tilstanden allerede i løpet av få timer etter oppstart av behandlingen. Prednisolondosen må over tid trappes gradvis ned, og det er svært viktig å følge legens anvisninger for å unngå alvorlige bivirkninger. Vanlig varighet av behandlingen er ett til to år. Enkelte kan bli nødt til å stå på lave doser (5-10 mg) vedlikeholdsbehandling i et par år eller lenger. 

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Langvarig bruk av kortison øker risikoen for å utvikle beinskjørhet. Det anbefales derfor daglig ta tilskudd av kalsium og vitamin D (f.eks. Calcigran®). De fleste vil også få anbefaling om å bruke reseptbelagt medisin mot benskjørhet (bisfosfonater).

Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Polymyalgia rheumatica . Referanselisten for dette dokumentet vises nedenfor

  1. Tengesdal S, Diamantopoulos AP, Brekke LK, et al. Polymyalgia rheumatica. Nasjonal veileder i revmatologi. Sist oppdatert 21.01.2025. metodebok.no
  2. Salvarani C, Cantini F, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. Lancet. 2008 Jul 19;372(9634):234-45. doi: 10.1016/S0140-6736(08)61077-6. PMID: 18640460 PubMed
  3. Buttgereit F, Dejaco C, Matteson EL, et al.. polymyalgia rheumatica and giant cell arteritis: a systematic review. JAMA 2016;315:2442–58. PMID: 27299619 PubMed
  4. González-Gay MA, Matteson EL, Castañeda S. Polymyalgia rheumatica. Lancet. 2017 Oct 7;390(10103):1700-1712. Epub 2017 Jul 31. PMID: 28774422. PubMed
  5. Weyand CM, Goronzy JJ. Clinical practice. Giant-cell arteritis and polymyalgia rheumatica. N Engl J Med. 2014 Jul 3;371(1):50-7. PMID: 24988557. PubMed
  6. Rosenberg H, Halman S, Yadav K. Polymyalgia rheumatica. CMAJ. 2021 Nov 22;193(46):E1770. PMID: 34810164 PubMed
  7. Ezeonyeji AN, Borg FA, Dasgupta B. Delays in recognition and management of giant cell arteritis: results from a retrospective audit. Clin Rheumatol. 2011;30(2):259–262.
  8. Gran JT, Myklebust G. Incidence and clinical characteristics of peripheral arthritis in polymyalgia rheumatica and temporal arteritis. Rheumatology 2000; 39: 283-7. Rheumatology
  9. Dasgupta B, Borg FA, Hassan N, et al. BSR and BHPR guidelines for the management of polymyalgia rheumatica. Rheumatology 2010; 49: 186-90. Rheumatology
  10. Kreiner F, Langberg H, Galbo H. Increased muscle interstitial levels of inflammatory cytokines in polymyalgia rheumatica. Arthritis Rheum. 2010;62(12):3768–3775.
  11. González-Gay MA, Pina T. Giant cell arteritis and polymyalgia rheumatica: an update. Curr Rheumatol Rep. 2015 Feb;17(2):6. PMID: 25618572 PubMed
  12. Gilden D, White T, Khmeleva N, et al. Prevalence and distribution of VZV in temporal arteries of patients with giant cell arteritis. Neurology 2015. DOI: 10.1212/WNL.0000000000001409 DOI
  13. Liozon E, Parreau S, Filloux M, et al. Giant cell arteritis or polymyalgia rheumatica after influenza vaccination: A study of 12 patients and a literature review. Autoimmunity Reviews 2021. pubmed.ncbi.nlm.nih.gov
  14. Dasgupta B, Cimmino MA, Maradit-Kremers H et al. 2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheum 2012; 65: 943-54. www.ncbi.nlm.nih.gov
  15. Macchioni P1, Boiardi L, Catanoso M, Pazzola G, Salvarani C. Performance of the new 2012 EULAR/ACR classification criteria for polymyalgia rheumatica: comparison with the previous criteria in a single-centre study. Ann Rheum Dis 2014; 73: 1190-3. pmid:24297384 PubMed
  16. Ozen G, Inanc N, Unal AU, et al. Assessment of the New 2012 EULAR/ACR Clinical Classification Criteria for Polymyalgia Rheumatica: A Prospective Multicenter Study. J Rheumatol 2016. pmid:26834222 PubMed
  17. Mackie SL, Hensor EM, Haugeberg G, Bhakta B, Pease CT. Can the prognosis of polymyalgia rheumatica be predicted at disease onset? Results from a 5-year prospective study. Rheumatology (Oxford). 2010;49(4):716–722.
  18. Breuer GS, Nesher G. What does imaging tell us about polymyalgia rheumatica? Rheumatology 2011; 51: 5-6. Rheumatology
  19. Dejaco C, Singh YP, Perel P, et al. 2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis. 2015; 74(10): 1799-807. Pmid: 26359488.
  20. Allen CS, Yeung JH, Vandermeer B, et al. Bisphosphonates for steroid-induced osteoporosis. Cochrane Database Syst Rev. 2016 Oct 5;10:CD001347. pmid: 27706804 PubMed
  21. Rosen HN, Saag KG. Prevention and treatment of glucocorticoid-induced osteoporosis. UpToDate. Sist revidert juni 2015. www.uptodate.com
  22. Marsman DE, den Broeder N, van den Hoogen FHJ, et al. Efficacy of rituximab in patients with polymyalgia rheumatica: a double-blind, randomised, placebo-controlled, proof-of-concept trial. Lancet Rheumatol 2021. doi:10.1016/S2665-9913(21)00245-9 DOI
  23. Devauchelle-Pensec V, Carvajal-Alegria G, Dernis E, et al. Effect of Tocilizumab on Disease Activity in Patients With Active Polymyalgia Rheumatica Receiving Glucocorticoid Therapy A Randomized Clinical Trial. JAMA 2022; 328: 1053-62. pmid:36125471 PubMed
  24. Spiera RF, Unizony S, Warrington KJ, et al. Sarilumab for relapse of polymyalgia rheumatica during glucocorticoid taper. N Engl J Med 2023 Oct 5; 389:1263. PMID: 37792612 PubMed
  25. Kermani TA, Warrington KJ, Cuthbertson D, et al. Disease relapses among patients with giant cell arteritis: A prospective, longitudinal cohort study. J Rheumatol 2015; 42:1213. doi: 10.3899/jrheum.141347 DOI
  26. Dejaco C, Duftner C, Cimmino MA, Dasgupta B, Salvarani C, Crowson CS, Maradit-Kremers H, Hutchings A, Matteson EL, Schirmer M; International Work Group for PMR and GCA. Definition of remission and relapse in polymyalgia rheumatica: data from a literature search compared with a Delphi-based expert consensus. Ann Rheum Dis. 2011;70:447–453
  27. Wu J, Keeley A, Mallen C et al. Incidence of infections associated with oral glucocorticoid dose in people diagnosed with polymyalgia rheumatica or giant cell arteritis: a cohort study in England. CMAJ 2019; 191: E680-8. pmid:31235489 PubMed
  28. Faurschou M, Ahlstrom MG, Lindhardsen J, et al. Risk of Diabetes mellitus among patients diagnosed with giant cell arteritis or granulomatosis with polyangiitis: Comparison with the general population. J Rheumatol. 2016 . PMID:27744394 PubMed
  29. Narváez J, Estrada P, López-Vives L, et al.. Prevalence of ischemic complications in patients with giant cell arteritis presenting with apparently isolated polymyalgia rheumatica. Semin Arthritis Rheum. 2015 Dec;45(3):328-33. doi: 10.1016/j.semarthrit.2015.06.009. Epub 2015 Jun 19. PMID: 26186807 PubMed
  30. De Miguel E, Macchioni P, Conticini E, Campochiaro C, Karalilova R, Monti S, Ponte C, Klinowski G, Monjo-Henry I, Falsetti P, Batalov Z, Tomelleri A, Hocevar A. Prevalence and characteristics of subclinical giant cell arteritis in polymyalgia rheumatica. Rheumatology (Oxford). 2024 Jan 4;63(1):158-164. doi: 10.1093/rheumatology/kead189. PMID: 37129541 PubMed
  31. Hancock AT, Mallen CD, Muller S, et al. Risk of vascular events in patients with polymyalgia rheumatica. CMAJ. 2014 Jul 28.
  32. Pujades-Rodriguez M, Duyx B, Thomas SL, et al. Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart 2016. doi:10.1136/heartjnl-2015-308514 DOI
  33. Dasgupta B, Borg FA, Hassan N, et al.; BSR and BHPR Standards, Guidelines and Audit Working Group. BSR and BHPR guidelines for the management of polymyalgia rheumatica. Rheumatology (Oxford). 2010;49(1):186–190.
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