Comparing the efficacy of low-dose prednisone monotherapy and combined therapy with methotrexate in the treatment of polymyalgia rheumatica
Objective:To investigate the efficacy and safety of low-dose prednisone monotherapy in the treatment of polymyalgia rheumatica(PMR).Methods:Forty untreated PMR patients were included and randomly divided into low-dose prednisone monotherapy group and combined therapy with prednisone and methotrexate group(prednisone group and prednisone+MTX group,both n=20)according to the random number table method.A prospective follow-up comparative study was conducted for 6 months.The clinical data,including erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),morning stiffness time and PMR activity score,were recorded at baseline and 6 months after treatment,and the efficacy and safety were compared between two groups.Results:Compared with baseline,ESR,CRP,morning stiffness time and PMR activity score in both groups were significantly improved after 6 months of treatment(P<0.05).There was no significant difference in the 6-month effective rates(85.00%vs.80.00%),time to complete remission[(4.14±1.78)months vs.(3.60±1.71)months]and effective treatment time[2.00(1.00,5.00)months vs.1.00(1.00,2.75)months]between the two groups(all P>0.05).No other adverse reactions were observed in both groups except for mild increase in fasting blood glucose and liver function damage.Conclusion:Low-dose prednisone monotherapy is clinically effective in the treatment of PMR with mild side effects.