Polymyalgia rheumatica (PMR) treatment is based on low-dose glucocorticoids. Lately, glucocorticoid-sparing agents have been tested with conflicting results. Hernández-Rodríguez et al investigate the treatment of PMR by systematically examining the peer-reviewed English-language literature on PMR therapy of all studies with 20 or more patients with PMR. Thirty studies (13 randomized trials and 17 observational studies) were finally analyzed. No meta-analyses or systematic reviews were found. Although this review remarks on the scarcity of randomized trials and the high level of heterogeneity among studies on PMR therapy, hence not allowing firm conclusions to be drawn, findings suggest that PMR remission may be achieved with prednisone treatment at a dose of 15 mg/d in most patients, and reductions below 10 mg/d should preferably follow a tapering rate of less than 1 mg/mo. Among all the glucocorticoid-sparing agents tested, an initial addition of oral or intramuscular methotrexate provided efficacy at doses of 10 mg/wk or higher.