PMID- 37185203
OWN - NLM
STAT- MEDLINE
DCOM- 20231222
LR  - 20240103
IS  - 1536-7355 (Electronic)
IS  - 1076-1608 (Linking)
VI  - 30
IP  - 1
DP  - 2024 Jan 1
TI  - Risk Factors for Relapse and/or Prolonged Glucocorticoid Therapy in Polymyalgia 
      Rheumatica: Multicenter Study in 185 Patients.
PG  - e34-e38
LID - 10.1097/RHU.0000000000001969 [doi]
AB  - BACKGROUND: In polymyalgia rheumatica (PMR) relapses and long-term GC dependency 
      are common. We assessed risk factors for higher relapse rate and/or prolonged 
      glucocorticoid therapy in PMR patients. METHODS: A multicenter and observational 
      study (chart review) of PMR patients seen between 2006 and 2021 who had at least 
      a 3-month follow-up period after starting GCs was performed. Results were 
      expressed as median and interquartile range 25th-75th or mean +/- standard 
      deviation for numerical variables and percentage for categorical ones. Relapse 
      versus nonrelapse groups were compared using Cox proportional analysis. Hazards 
      ratios (HRs) with 95% confidence intervals (CIs) are reported. In all cases, a p 
      value <0.05 was considered to indicate statistical significance. RESULTS: We 
      included 185 patients (69.1% female). The median follow-up time was 17.1 months 
      (interquartile range, 6.8-34.7). Incidence of relapses was 1.2 per 100 
      persons/month. In univariate analysis, PMR patients with a previous history of 
      dyslipidemia had a lower risk of relapse (HR, 0.55; 95% CI, 0.33-0.94; p = 0.03); 
      high-dose GC (HR, 2.35; 95% CI, 1.42-3.87; p = 0.001) and faster GC dose 
      reduction had higher risk of relapse (HR, 3.04; 95% CI, 1.77-5.21; p = 0.001). In 
      multivariate analysis, a previous history of dyslipidemia had a lower risk of 
      relapse (HR, 0.54; 95% CI, 0.32-0.92; p = 0.023), and high dose of GC (HR, 2.46; 
      95% CI, 1.49-4.08; p = 0.001) remained the only risk factors for relapse. 
      CONCLUSIONS: Lower doses of corticosteroids and a slow rate of reduction are 
      critical to avoid relapse in PMR. Risk factors for higher relapse rate rely on 
      therapy more than clinical characteristics of the patients at the time of 
      diagnosis of PMR.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Vinicki, Juan Pablo
AU  - Vinicki JP
AD  - From the Seccion Reumatologia, Hospital de Quilmes.
FAU - Gut, Oscar
AU  - Gut O
AD  - Centro Medico Privado, Buenos Aires.
FAU - Maliandi, Maria Del Rosario
AU  - Maliandi MDR
AD  - Unidad de Reumatologia, Sanatorio Garay, Santa Fe.
FAU - Velasco Zamora, Jose Luis
AU  - Velasco Zamora JL
AD  - Instituto de Investigaciones Clinicas, Quilmes.
FAU - Linarez, Miguel
AU  - Linarez M
AD  - Obra Social del Personal Maritimo.
FAU - Cusa, Maria Alejandra
AU  - Cusa MA
AD  - Medicina Reumatologica, Centro Medico Privado, Buenos Aires.
FAU - Got, Julio
AU  - Got J
AD  - Unidad de Reumatologia, Instituto Medico Humanitas, Chaco.
FAU - Spinetto, Maria Andrea
AU  - Spinetto MA
AD  - Centro Medico Privado, Buenos Aires.
FAU - Estevez, Adrian Jorge
AU  - Estevez AJ
AD  - Unidad de Inmunoreumatologia, Hospital El Cruce.
FAU - Brigante, Alejandro
AU  - Brigante A
AD  - Seccion Reumatologica, Sanatorio Guemes, Buenos Aires.
FAU - Curti, Ana Carolina
AU  - Curti AC
AD  - Centro Medico Privado, Mendoza.
FAU - Costi, Ana Carolina
AU  - Costi AC
AD  - Servicio de Reumatologia, HIGA San Martin de La Plata, Buenos Aires.
FAU - Cavallasca, Javier
AU  - Cavallasca J
AD  - Seccion Reumatologia, Hospital Jose Bernardo Iturraspe, Santa Fe, Argentina.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20230426
PL  - United States
TA  - J Clin Rheumatol
JT  - Journal of clinical rheumatology : practical reports on rheumatic & 
      musculoskeletal diseases
JID - 9518034
RN  - 0 (Glucocorticoids)
SB  - IM
MH  - Humans
MH  - Female
MH  - Male
MH  - *Polymyalgia Rheumatica/diagnosis/drug therapy
MH  - Glucocorticoids
MH  - *Giant Cell Arteritis/diagnosis/drug therapy
MH  - Risk Factors
MH  - Recurrence
MH  - *Dyslipidemias/chemically induced/drug therapy
EDAT- 2023/05/15 19:12
MHDA- 2023/12/22 06:42
CRDT- 2023/05/15 13:22
PHST- 2023/12/22 06:42 [medline]
PHST- 2023/05/15 19:12 [pubmed]
PHST- 2023/05/15 13:22 [entrez]
AID - 00124743-990000000-00108 [pii]
AID - 10.1097/RHU.0000000000001969 [doi]
PST - ppublish
SO  - J Clin Rheumatol. 2024 Jan 1;30(1):e34-e38. doi: 10.1097/RHU.0000000000001969. 
      Epub 2023 Apr 26.