Family Nurse Practitioner Exam

Which medication is considered first-line treatment for polymyalgia rheumatica?

1. Etanercept (Enbrel)

2. Oral prednisone

3. Indomethacin

4. Methotrexate

The correct answer is: Oral prednisone

Oral prednisone is considered the first-line treatment for polymyalgia rheumatica because this condition is characterized by significant muscle pain and stiffness, particularly in the shoulder and hip regions. The inflammation associated with polymyalgia rheumatica responds well to glucocorticoids like prednisone, which effectively reduce inflammation and provide symptom relief. Starting treatment with oral prednisone is especially beneficial as it can lead to rapid improvement in symptoms, which is a key consideration in managing this condition. Typically, low doses are used, and the dose may be gradually reduced over time as the patient's symptoms improve. While other medications like etanercept, indomethacin, and methotrexate may be used in certain inflammatory conditions or as second-line treatments, they are not first-line therapies for polymyalgia rheumatica. Etanercept is a biologic aimed at rheumatoid arthritis treatment; indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) generally used for other conditions like gout; and methotrexate, although useful in chronic inflammatory disorders, is not the initial treatment of choice for this specific condition. Thus, oral prednisone's role in rapidly addressing inflammation and symptoms makes it the preferred first-line agent for polymyalgia rheumatica