. 53 year old male presents with pain in LT leg joint for 5 day . at morning feel stiffness in joint . no swelling or redness . no history of fall . past history of HTN for last 5 years. After some investigation doctor need start corticosteroid for suspect polymyalgia rheumatic until more evaluation . what is regimen to start corticosteroid therapy :
A . Daily prednisolone 15mg for 3 weeks ,then 12.5mg for 3 weeks , then 10mg
B . Daily prednisolone 20mg for 2 weeks ,then 10mg for 2 weeks , then 5mg
C . Daily prednisolone 40mg for 3 weeks ,then 20mg for 3 weeks , then 10mg
D . Daily prednisolone 10mg for 4 weeks ,then 5mg for 2 weeks , then 2.5mg
E . Daily prednisolone 30mg for 1 weeks ,then 20mg for 1 weeks , then 10mg
Explanation :
Answer : A We recommend initiation of low-dose steroid therapy with gradually tailored tapering in straightforward PMR . In the absence of GCA, urgent steroid therapy is not
indicated before the clinical evaluation is complete. The suggested regimen is:
. Daily prednisolone 15mg for 3 weeks
. Then 12.5mg for 3 weeks
. Then 10mg for 4–6 weeks
. Then reduction by 1mg every 4–8 weeks or alternate day reductions