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Adverse events during longterm low-dose glucocorticoid treatment of polymyalgia rheumatica: a retrospective study

Maurizio Mazzantini1, Claudia Torre, Mario Miccoli

  • 1Rheumatology Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy. mmazzant@int.med.unipi.it

The Journal of Rheumatology
|January 17, 2012
PubMed
Abstract

Insights

Low-dose glucocorticoids (GC) for polymyalgia rheumatica (PMR) can lead to serious adverse events like osteoporosis and fractures, particularly after two years of treatment. Careful monitoring is essential for patients on long-term GC therapy.

Area of Science:

  • Rheumatology
  • Endocrinology
  • Pharmacology

Background:

  • Polymyalgia rheumatica (PMR) is often treated with low-dose glucocorticoids (GC).
  • Long-term GC use is associated with potential adverse events.
  • Assessing these risks in PMR patients is crucial for patient safety.

Purpose of the Study:

  • To evaluate the incidence and types of adverse events in patients with PMR receiving low-dose GC therapy.
  • To identify risk factors associated with these adverse events.

Main Methods:

  • Retrospective study involving the review of medical records of 222 PMR patients.
  • Analysis of patient data including duration of follow-up, GC therapy duration, and cumulative GC dose.
  • Statistical analysis (univariate and multivariate) to determine associations between GC treatment and adverse events.

Main Results:

  • 43% of patients experienced at least one adverse event.
  • Common adverse events included osteoporosis (55 patients), fragility fractures (31), and arterial hypertension (27).
  • Longer GC treatment duration and higher cumulative doses were significantly associated with increased risk of osteoporosis, fractures, and hypertension, especially after two years.

Conclusions:

  • Long-term, low-dose GC treatment for PMR is linked to significant adverse events, including osteoporosis, fractures, and hypertension.
  • These adverse events predominantly manifest after two years of treatment.
  • Clinical vigilance and monitoring are recommended for PMR patients on extended GC therapy.

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