What is considered the first-line treatment for polymyalgia rheumatica?

Oral prednisone is considered the first-line treatment for polymyalgia rheumatica due to its rapid anti-inflammatory effects, which are critical in managing the symptoms associated with this condition. Polymyalgia rheumatica typically presents with bilateral pain and stiffness in the shoulder and hip areas, often significantly impairing daily activities.

Prednisone, a corticosteroid, targets the underlying inflammatory processes, providing relief from pain and restoring function relatively quickly. The dosing is usually low, allowing for adjustment based on the patient's response, and it is effective in managing the symptoms while minimizing the risk of side effects when used judiciously.

Other treatments, such as etanercept, indomethacin, and methotrexate, are not considered first-line for polymyalgia rheumatica. Etanercept is a biologic agent primarily used in rheumatoid arthritis and other autoimmune conditions, whereas indomethacin, a nonsteroidal anti-inflammatory drug (NSAID), has less efficacy in this particular condition. Methotrexate might be used in cases where corticosteroids are insufficient or for long-term management, but it is not the initial treatment of choice. The strong evidence supporting the use of oral prednisone establishes its status as the first-line intervention in managing polymy