Quick summary of guidelines in this month’s BJGP, plus reference to the full version, which is in this article. Not much that I didn’t already know, but current guidelines are for 3 weeks at 15 mg pred, 3 at 12.5, 4 – 6 at 10 mg, and then 4 – 8 at each 1 mg reduction. Review 1/52 after diagnosis, weeks 3 and 6, and then at 3, 6, 9, and 12 months after diagnosis – this schedule should be flexible and individualised for each patient. Assessments should include questions about TA symptoms. Relapse should be treated by increasing steroid dose to the dose that previously controlled symptoms, but more than two relapses should be a reason for referral for consideration of methotrexate or similar in order to spare total steroid burden.
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