Women With Polymyalgia Rheumatica Face Higher Steroid Exposure

A US retrospective cohort study found women received higher cumulative glucocorticoid doses than men over three years of treatment.

Updated on Nov. 6, 2026 in Arthritis

Bold vector editorial illustration of graduated amber glass vessels rising in height across a pale surface, conveying accumulating steroid exposure. — A retrospective US cohort study of 1,899 patients with polymyalgia rheumatica found women received higher cumulative steroid doses than men over three years. AI Illustration. Upload story photo >

A retrospective cohort study of 1,899 patients aged 50 or older with polymyalgia rheumatica found women received higher cumulative glucocorticoid doses than men by three years. Greater steroid exposure was associated with higher odds of new or worsening hypertension and type 2 diabetes.

Why it matters

The findings suggest sex-based differences in steroid-related complications that could shape how clinicians monitor patients with polymyalgia rheumatica. Fragility fractures and giant cell arteritis were also more common in women during the study period.

Among 1,899 patients, the composite outcome occurred in 36.7% of women versus 31.3% of men at 3 years (P = .040), and giant cell arteritis occurred in 7.6% of women versus 3.4% of men (P ≤ .001). Adjusted odds ratios were 1.82 for hypertension and 1.85 for type 2 diabetes, though causality was not established.

The players

Mayo Clinic

Mayo Clinic is a nonprofit academic medical center headquartered in Rochester, Minnesota, with a major campus in Scottsdale, Arizona, where the lead author's institution is based.

The details

Researchers converted oral prednisone and methylprednisolone doses to prednisone-equivalent amounts to measure cumulative and daily exposure. Analyses adjusted for age, BMI, treatment site, and baseline type 2 diabetes, with patients treated between 2017 and 2024 and results published November 4, 2026, in ACR Open Rheumatology.

2017 to 2024: Patients were treated at the multisite US health system included in the study.
3 years: Women showed higher glucocorticoid dose, composite outcome, and fracture rates than men.
November 4, 2026: Study was published online in ACR Open Rheumatology.

Health Landscape

The study adds sex-specific evidence to ongoing observational research on glucocorticoid toxicity in polymyalgia rheumatica, a condition typically treated with long courses of steroids. It points to a potential gap in how steroid-related risks are assessed across male and female patients.

Patients with polymyalgia rheumatica who take long courses of prednisone may want to discuss steroid dose, bone health, and blood pressure and glucose monitoring with their clinicians. The findings do not change current treatment guidelines, and patients should not alter their medication without medical advice.

The takeaway

Clinicians may consider tracking cumulative steroid exposure and its complications separately for men and women with polymyalgia rheumatica. Patients can ask their care teams how long-term steroid use may affect bones, blood pressure, and blood sugar.