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Clinical characteristics and prognostic factors for relapse in patients with polymyalgia rheumatica (PMR)

Jung Hwa Lee1, Sang Tae Choi, Jin Su Kim

  • 1Division of Rheumatology, Department of Internal Medicine, Konkuk University School of Medicine, 4-12 Hwayang-dong Gwangjin-gu, Seoul 143-729, Korea.

Rheumatology International
|November 28, 2012
PubMed

Insights

Polymyalgia rheumatica (PMR) in Korean patients shows similar characteristics to Western populations but with a lower remission rate. Relapse risk factors include high initial C-reactive protein and hydroxychloroquine use, suggesting a need for tailored management strategies.

Area of Science:

  • Rheumatology
  • Epidemiology
  • Internal Medicine

Background:

  • Polymyalgia rheumatica (PMR) is a common inflammatory condition in the elderly, with varying prevalence across different populations.
  • Epidemiological data on PMR in Korea is limited, necessitating further investigation into its characteristics within this demographic.

Purpose of the Study:

  • To retrospectively evaluate the clinical data of Korean patients diagnosed with PMR.
  • To analyze initial laboratory findings, symptoms, treatment responses, and prognostic factors for relapse within one year.

Main Methods:

  • Retrospective analysis of clinical data from 78 PMR patients treated at five tertiary hospitals.
  • Evaluation of initial laboratory data, symptoms, therapeutic responses, and relapse rates at one year.

Main Results:

  • Sixty percent of patients experienced shoulder and hip girdle pain, with elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
  • The 1-year relapse rate was 38.4%, with overall relapse at 46.1%, occurring predominantly within the first year.
  • Independent risk factors for relapse included initial CRP ≥ 2.5 mg/dl and hydroxychloroquine use; female gender and higher cumulative steroid dose were associated with relapse.

Conclusions:

  • Korean PMR patients exhibit similar baseline characteristics and relapse rates to Western cohorts but notably lack associated giant cell arteritis.
  • Lower remission rates, delayed therapeutic response, and later relapse occurrence were observed in this Korean cohort.
  • More aggressive and individualized management strategies may be required for Korean patients with PMR based on their clinical status and identified risk factors.

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