Muller, SN ORCID: https://orcid.org/0000-0001-6645-5751, Hider, SL ORCID: https://orcid.org/0000-0002-9958-3909, Sokhal, BS, Lawton, SA ORCID: https://orcid.org/0000-0002-8909-2057, Helliwell, T ORCID: https://orcid.org/0000-0003-3987-6045 and Mallen, CD ORCID: https://orcid.org/0000-0002-2677-1028 (2022) Long-term use of glucocorticoids for polymyalgia rheumatica: follow-up of the PMR Cohort Study. Rheumatology Advances in Practice, 6 (2).

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Abstract

Objectives PMR is a common inflammatory condition in older adults, characterized by bilateral hip and shoulder pain and stiffness. Reducing oral glucocorticoids, classically used for <= 2 years, are the mainstay of treatment. This study considers the factors early in the disease course that might be associated with prolonged treatment. Methods Six hundred and fifty-two people with incident PMR were recruited from English general practices (2012-2014). Participants completed seven questionnaires over 2 years (used to allocate people to pain-stiffness trajectories) and a further long-term follow-up (LTFU) questionnaire a median of 5.16 years after diagnosis. Characteristics of those still taking and having ceased glucocorticoids were described and compared using Kruskal-Wallis and chi(2) and Student's 2-sample t-tests as appropriate. Results Of the 197 people completing the LTFUQ questionnaire, 179 people reported ever having taken glucocorticoids. Of these, 40.1% were still on treatment, with a median (quartile 1, quartile 3) daily dose of 5 (1.5, 9) mg. People still taking glucocorticoids were more likely to be older (72.5 vs 70.2 years, P = 0.035), live alone (31.8 vs 15.0%, P = 0.01) and have self-managed their glucocorticoid dose (39.1 vs 11.0%, P < 0.0001). They were also more likely to belong to a pain-stiffness trajectory class with sustained symptoms. Conclusions PMR is not always a time-limited condition. Few patient characteristics are associated with prolonged treatment early in the disease course, but those who are older and who have sustained symptoms might be at greater risk. Although accurate prediction is not yet possible, clinicians should monitor people with PMR carefully to manage symptoms and reduce the cumulative glucocorticoid dose.

Item Type: Article
Additional Information: This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Uncontrolled Keywords: PMR, cohort studies, primary health care
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 06 Jun 2022 13:34
Last Modified: 05 Jul 2022 09:15
URI: https://eprints.keele.ac.uk/id/eprint/10927

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