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Fatigue as a precursor to polymyalgia rheumatica: an explorative retrospective cohort study
D J Green1, S Muller, C D Mallen
1Arthritis Research UK Primary Care Centre, Keele University , Staffordshire , UK.
Scandinavian Journal of Rheumatology
|November 5, 2014
Summary
Patients with polymyalgia rheumatica (PMR) often experience fatigue, which may be a prodromal symptom. Early consideration of PMR in older adults presenting with fatigue can aid diagnosis.
Area of Science:
- Rheumatology
- Geriatrics
- General Practice
Background:
- Polymyalgia rheumatica (PMR) is a common inflammatory condition in older adults.
- Fatigue is a frequent complaint in PMR patients, though not a primary classification criterion.
- The relationship between PMR and fatigue consultations requires further investigation.
Purpose of the Study:
- To compare consultations for fatigue and sleep problems in individuals with and without PMR.
- To investigate if fatigue consultations precede a PMR diagnosis.
Main Methods:
- A case-control study matching PMR patients with non-PMR controls.
- Utilized Read codes to identify diagnoses of PMR, fatigue, and sleep problems.
- Employed Cox regression to analyze the association between PMR and fatigue/sleep consultations.
Main Results:
- PMR patients had significantly more fatigue consultations in the 12 months preceding diagnosis (HR 1.95).
- No significant difference in sleep problem consultations was observed between groups.
- Fatigue consultations were more frequent in PMR patients prior to diagnosis (0.43 vs. 0.25 per 10,000 person-years).
Conclusions:
- Increased fatigue consultations may indicate a prodromal phase of PMR.
- Clinicians should consider PMR in older patients presenting with unexplained fatigue.
- Fatigue, potentially linked to inflammatory cytokines, warrants attention in PMR diagnosis.
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