What is the treatment plan for managing polymyalgia rheumatica (PMR) and how does it affect bone health?

Polymyalgia rheumatica (PMR) is an inflammatory disease that causes pain and stiffness in the muscles. Common treatments include corticosteroids, methotrexate, and sometimes NSAIDs or a biologic drug like sarilumab (Kevzara). Corticosteroids like prednisone are usually the first line of treatment and work quickly to relieve symptoms. However, long-term use can weaken bones, increasing the risk of fractures. To counteract this, doctors may recommend calcium and vitamin D supplements or bisphosphonates. Methotrexate can be added to reduce the necessary steroid dose. NSAIDs are generally not recommended for long-term use due to potential side effects. Biologic drugs like Kevzara are used if other treatments fail. It's important to follow the treatment plan and not stop medications abruptly to avoid relapses.