Women With Polymyalgia Rheumatica Face Higher Steroid Use
Women with polymyalgia rheumatica received more cumulative glucocorticoids than men by three years, with higher rates of fractures and metabolic complications.
Updated on Nov. 6, 2026 in Arthritis
A retrospective study of 1,899 patients aged 50 and older with polymyalgia rheumatica found that women received higher cumulative glucocorticoid doses than men by three years of treatment. Greater steroid exposure was associated with higher odds of new or worsening hypertension and type 2 diabetes, and the findings were published November 4, 2026, in ACR Open Rheumatology.
Why it matters
Polymyalgia rheumatica is commonly treated with glucocorticoids, and this analysis suggests women in the study may have faced greater cumulative steroid burden and more related complications over time. Because the study tracked treatment at a multisite U.S. health system between 2017 and 2024, it offers a real-world look at how steroid exposure may differ by sex in routine care.
This retrospective cohort study analyzed 1,899 patients aged 50 or older with polymyalgia rheumatica, including 915 women, with a mean age of 72.5 years. Findings were adjusted for age, BMI, treatment site, and baseline type 2 diabetes, and the study does not establish that steroid dose directly caused the complications observed.
The players
ACR Open Rheumatology
An open-access journal from the American College of Rheumatology that publishes research on rheumatic and musculoskeletal diseases.
Mayo Clinic
A large academic medical center in Scottsdale, Arizona, the lead author's institution, known for research and care across rheumatic and other chronic conditions.
The details
Oral prednisone and methylprednisolone doses were converted to prednisone-equivalent doses so researchers could calculate cumulative and daily glucocorticoid exposure for each patient. At one year, cumulative dose and the composite outcome did not differ by sex, but by three years women showed higher glucocorticoid exposure, more composite outcomes, and more fragility fractures and giant cell arteritis. Glucocorticoids are known to affect blood sugar and blood pressure, which is consistent with the higher odds of hypertension and type 2 diabetes linked to greater steroid dose.
Timeline
Patients were treated at the multisite U.S. health system between 2017 and 2024.
At one year, cumulative dose and the composite outcome did not differ by sex.
By three years, women showed higher glucocorticoid dose, composite outcomes, and fractures.
The study was published online in ACR Open Rheumatology on November 4, 2026.
Health Landscape
Glucocorticoids remain a standard treatment for polymyalgia rheumatica, but long-term exposure carries known risks for blood sugar, blood pressure, bone health, and vascular inflammation. This study adds sex-specific evidence to ongoing efforts to balance effective symptom control against cumulative steroid-related harm.
If you have polymyalgia rheumatica, it is worth asking your doctor how long you are on glucocorticoids and whether your blood pressure, blood sugar, and bone health are being monitored over time. Women on long-term steroid therapy may want to specifically discuss fracture risk and the ongoing need for the current dose with their clinician.
The takeaway
Long-term glucocorticoid use for polymyalgia rheumatica may carry cumulative risks, and this study suggests women could face higher steroid exposure and related complications over three years. Ask your physician to review your steroid dose and monitor blood pressure, blood sugar, and bone health regularly.
Further reading
For more on the conditions that steroid treatment is used to manage, explore our Arthritis coverage.
Source note: This article includes information reported by Medscape.
