| Contribution of the Polymyalgia Rheumatica Activity Score to Glucocorticoid Dosage Adjustment in Everyday Practice. | |
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MedLine Citation:
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PMID: 22174199 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the usefulness of the polymyalgia rheumatica (PMR) activity score (PMR-AS) in guiding adjustment of glucocorticoid (GC) dosage. METHODS: Rheumatologists prospectively included patients receiving GC therapy for PMR. At each visit, they assessed disease activity using a visual analog scale for physician's global assessment (VASph) and recorded whether a flare was diagnosed and/or the GC dosage was changed. In each patient, the PMR-AS was calculated using the formula of Leeb and Bird: C-reactive protein (mg/dl) + VAS pain score (0 to 10) + VASph (0 to 10) + (morning stiffness in min × 0.1) + elevation of upper limbs (0-3). We evaluated the correlation between PMR-AS and GC dosage changes in the group already treated with GC. RESULTS: We included 89 patients (mean age 74.6 ± 6.2 yrs; disease duration 1.6 ± 2.2 yrs), who had a total of 149 visits. PMR-AS was available for 137 visits. Of those, 124 involved patients already treated with GC, and 13 patients who started GC treatment. The Spearman correlation coefficient between PMR-AS values and GC dosage change was 0.58 (p < 0.001). In the group already treated with GC, when the PMR-AS was higher than 20, GC dosages were never decreased. When the PMR-AS was between 10 and 20, GC dosages were decreased in 4 patients, unchanged in 4, and increased by < 5 mg in 4 patients. When PMR-AS was < 10, GC dosages were generally decreased. CONCLUSION: The PMR-AS is helpful for diagnosing flares of PMR and may also assist in everyday practice to decide how to change the GC dosage. |
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Authors:
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Caroline Cleuziou; Aymeric Binard; Michel De Bandt; Jean-Marie Berthelot; Alain Saraux |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-15 |
Journal Detail:
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Title: The Journal of rheumatology Volume: - ISSN: 0315-162X ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7501984 Medline TA: J Rheumatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Rheumatology Unit, Brest Teaching Hospital, Brest; Rheumatology Unit, Robert Ballanger Hospital, Aulnay sous Bois; and the Rheumatology Unit, Nantes Teaching Hospital, Nantes, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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