{
  "abstract": "OBJECTIVES: This study aimed to update the European Alliance of Associations for Rheumatology (EULAR) recommendations for management of polymyalgia rheumatica (PMR), giant cell arteritis (GCA), and Takayasu arteritis (TAK). METHODS: Following EULAR standard operating procedures, systematic literature reviews identified data published since the previous versions for PMR (2015) and for GCA/TAK (2018). An international task force discussed the evidence, and following a structured voting process, created overarching principles, recommendations, and quality indicators. RESULTS: The task force agreed on 4 overarching principles, 12 recommendations, and 2 quality indicators. All patients with suspected PMR, GCA, or TAK should be referred for specialist assessment and those with suspected GCA within 24 hours. In patients with a strong clinical suspicion of GCA, treatment with glucocorticoids (GCs) should be commenced without delay, while waiting for the results of confirmatory investigations. For most patients with suspected PMR or TAK, treatment with GC can be delayed until the diagnosis is confirmed. For induction of remission, GC should be initiated at a dose of 15 to 25 mg/day prednisone-equivalent for PMR and 40 to 60 mg for GCA or TAK. Guidance on GC tapering is provided. Adjunctive therapy is recommended for selected patients with PMR or GCA using either interleukin (IL)-6 receptor inhibitors for PMR and GCA or upadacitinib for GCA. Methotrexate may be an alternative. GC-sparing agents should be given in combination with GC to all patients with TAK. All overarching principles and recommendations met with high levels of agreement. CONCLUSIONS: Updated guidance on management of PMR and large vessel vasculitis is provided in a single set of practical recommendations and algorithms.",
  "abstract_shown": true,
  "affiliations": [
    "Vasculitis Unit, Department of Rheumatology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK. Electronic address: chetan.mukhtyar@nnuh.nhs.uk",
    "Centre for Rheumatic Diseases, Faculty of Life Sciences & Medicine, School of Immunology & Microbial Sciences, King's College London, London, UK; Centre for Education, Faculty of Life Sciences & Medicine, King's College London, London, UK; Department of Rheumatology, King's College Hospital NHS Foundation Trust, London, UK",
    "Vasculitis Unit, Department of Rheumatology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK; Department of Rheumatology, ASST Gaetano Pini CTO, Milan, Italy",
    "Centre for Rheumatic Diseases, Faculty of Life Sciences & Medicine, School of Immunology & Microbial Sciences, King's College London, London, UK",
    "Vasculitis Unit, Department of Rheumatology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK",
    "Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India",
    "Unit of Immunology, Allergology and Rheumatology, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy",
    "Department of Internal Medicine 3, Division of Rheumatology, Medical University of Vienna, Vienna, Austria",
    "Unit of Rheumatology, S. Chiara Hospital, ASUIT Trento, and Center for Medical Sciences (CISMed), Department of Cellular, Computational and Integrative Biology (diCIBIO), University of Trento, Italy",
    "Department of General Internal Medicine, University Hospitals Leuven and Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium",
    "Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands",
    "Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin, and Deutsches Rheumaforschungszentrum Berlin, Berlin, Germany",
    "Patient Research Partner",
    "Department of Autoimmune Diseases. Hospital Clínic. University of Barcelona, Institut d'Investigacions Biomèdiques August pi i Sunyer (IDIBAPS), Barcelona, Spain",
    "Discipline of Clinical Medicine, Trinity College Dublin, Dublin, Ireland, and Department of Rheumatology, St. James's Hospital, Dublin, Ireland",
    "Department of Rheumatology and Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland",
    "Department of Rheumatology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Brunico (SABES-ASDAA), Teaching Hospital of the Paracelsus University, Brunico, Italy",
    "Department of Rheumatology, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark",
    "Division of Rheumatology, Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA",
    "Department of Clinical Sciences, Rheumatology, Lund University, Lund, Sweden and Department of Rheumatology, Skåne University Hospital, Lund, Sweden",
    "Ophthalmology Department, Queen's University, Kingston, Ontario, Canada; Metabolism and Systems Research, School of Medical Sciences, University of Birmingham, Edgbaston, United Kingdom",
    "Department of Rheumatology, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark; Department of Internal Medicine, Horsens Regional Hospital, Horsens, Denmark",
    "Rheumatology Department, ULS de Santa Maria, Centro Académico de Medicina de Lisboa, Lisbon, Portugal; Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal",
    "Department of Rheumatology, Waldfriede Hospital, Berlin, Germany",
    "Department of Medicine, Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA",
    "Klinik für Innere Medizin, Rheumatologie, Pneumologie, Nephrologie und Diabetologie, Medius Kliniken, Akademisches Lehrkrankenhaus der Universität Tübingen, Kirchheim unter Teck, Germany"
  ],
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    {
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      ],
      "name": "Chetan B. Mukhtyar",
      "orcid": "0000-0002-9771-6667"
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    {
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        1
      ],
      "name": "Elena Nikiphorou",
      "orcid": "0000-0001-6847-3726"
    },
    {
      "affs": [
        2
      ],
      "name": "Alice Bartoletti",
      "orcid": "0009-0001-8242-6798"
    },
    {
      "affs": [
        3
      ],
      "name": "Mrinalini Dey",
      "orcid": "0000-0001-6858-4338"
    },
    {
      "affs": [
        4
      ],
      "name": "Georgina Ducker",
      "orcid": "0000-0002-9822-0604"
    },
    {
      "affs": [
        5
      ],
      "name": "Durga Prasanna Misra",
      "orcid": "0000-0002-5035-7396"
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    {
      "affs": [
        6
      ],
      "name": "Sara Monti"
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    {
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        7
      ],
      "name": "Paul Studenic",
      "orcid": "0000-0002-8895-6941"
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    {
      "affs": [
        8
      ],
      "name": "Alvise Berti",
      "orcid": "0000-0002-7831-921X"
    },
    {
      "affs": [
        9
      ],
      "name": "Daniël Blockmans",
      "orcid": "0000-0001-9783-1780"
    },
    {
      "affs": [
        10
      ],
      "name": "Elisabeth Brouwer",
      "orcid": "0000-0002-5652-4423"
    },
    {
      "affs": [
        11
      ],
      "name": "Frank Buttgereit",
      "orcid": "0000-0003-2534-550X"
    },
    {
      "affs": [
        12
      ],
      "name": "Kathleen Cannings"
    },
    {
      "affs": [
        13
      ],
      "name": "Maria Cinta Cid",
      "orcid": "0000-0002-4730-0938"
    },
    {
      "affs": [
        14
      ],
      "name": "Richard P. Conway",
      "orcid": "0000-0003-2538-3362"
    },
    {
      "affs": [
        15
      ],
      "name": "Lisa Christ",
      "orcid": "0000-0002-7358-2051"
    },
    {
      "affs": [
        16
      ],
      "name": "Christian Dejaco",
      "orcid": "0000-0002-0173-0668"
    },
    {
      "affs": [
        17
      ],
      "name": "Kresten Krarup Keller",
      "orcid": "0000-0003-2474-3389"
    },
    {
      "affs": [
        12
      ],
      "name": "Lisa Christ",
      "orcid": "0000-0002-7358-2051"
    },
    {
      "affs": [
        18
      ],
      "name": "Peter A. Merkel",
      "orcid": "0000-0001-9284-7345"
    },
    {
      "affs": [
        19
      ],
      "name": "Aladdin J Mohammad",
      "orcid": "0000-0002-7169-6936"
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    {
      "affs": [
        20
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      "name": "Susan P. Mollan",
      "orcid": "0000-0002-6314-4437"
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    {
      "affs": [
        21
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      "name": "Berit Dalsgaard Nielsen",
      "orcid": "0000-0001-6291-157X"
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    {
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        22
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      "name": "Cristina Ponte",
      "orcid": "0000-0002-3989-1192"
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    {
      "name": "David Saadoun",
      "orcid": "0000-0003-3628-9996"
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      "name": "Wolfgang Schmidt",
      "orcid": "0000-0001-7831-8738"
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      "name": "Kenneth J. Warrington",
      "orcid": "0000-0001-7708-2487"
    },
    {
      "affs": [
        25
      ],
      "name": "Bernhard Hellmich",
      "orcid": "0000-0002-8014-1801"
    }
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  "doi": "10.1016/j.ard.2026.06.009",
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  "licence_label": "CC BY-NC-ND",
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  "published": "2026-07-01",
  "publisher": "BMJ",
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  "title": "2025 EULAR recommendations for the management of polymyalgia rheumatica and primary large vessel vasculitis",
  "title_text": "2025 EULAR recommendations for the management of polymyalgia rheumatica and primary large vessel vasculitis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T13:20:51Z",
  "url": "https://research.draconitic.com/paper/159sy9qtfd298",
  "venue": "Annals of the Rheumatic Diseases",
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