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Longterm therapy in polymyalgia rheumatica: effect of coexistent temporal arteritis
J Narváez1, J M Nolla-Solé, M T Clavaguera
1Department of Rheumatology, Hospital Principes de España, Ciudad Sanitaria y Universitaria de Bellvitge, Barcelona, Spain.
The Journal of Rheumatology
|September 24, 1999
Summary
Polymyalgia rheumatica (PMR) treatment often requires corticosteroids for at least two years. Factors like older age and female sex predict longer steroid use, but not relapse risk.
Area of Science:
- Rheumatology
- Clinical Medicine
- Epidemiology
Background:
- Polymyalgia rheumatica (PMR) is an inflammatory condition.
- Long-term corticosteroid (CS) therapy is common in PMR management.
- The influence of coexisting temporal arteritis (TA) on PMR outcomes requires further analysis.
Purpose of the Study:
- To analyze the clinical course and duration of therapy in 104 PMR patients.
- To identify factors associated with prolonged steroid use and relapses in PMR.
- To assess the impact of temporal arteritis (TA) on PMR treatment duration and relapse rates.
Main Methods:
- Retrospective study of 104 patients diagnosed with PMR between 1985 and 1995.
- Kaplan-Meier survival analysis and log-rank tests were used to evaluate therapy duration, remission, and relapse.
- Multivariate Cox proportional hazards regression identified predictors of long-term therapy and relapse.
Main Results:
- 69 patients had pure PMR, and 35 had both PMR and TA. Most patients required CS therapy for at least two years.
- Patients with TA showed longer therapy duration but not an increased relapse risk.
- Increased age, female sex, higher ESR, and lower CS dose were linked to prolonged therapy; no clinical feature predicted relapse.
Conclusions:
- PMR treatment typically involves corticosteroids for a minimum of two years.
- Identifying patients predisposed to prolonged or high-dose steroid therapy is crucial.
- Preventive strategies are needed to mitigate steroid-related adverse events in susceptible PMR patients.