OBJECTIVE: To evaluate the effectiveness of the polymyalgia rheumatica activity score (PMR-AS) in diagnosing disease flares. METHODS: Rheumatologists prospectively included 89 patients with PMR (mean +/- SD age 74.6 +/- 6.2 years, mean +/- SD disease duration 1.6 +/- 2.2 years). At each visit, the rheumatologist assessed disease activity using a visual analog scale (VAS) and recorded whether a disease flare was diagnosed and/or the glucocorticoid dose changed. Overall, 137 visits including 49 pairs (allowing intraindividual comparisons) were available; a disease flare was diagnosed at 32 visits. We evaluated statistical associations linking flare diagnosis to the PMR-AS, each of its components (VAS, VAS for pain, C-reactive protein, morning stiffness, and elevation of upper limbs), and changes in these parameters between 2 visits. RESULTS: Associations with disease flare diagnosis were strongest for PMR-AS scores > or =9.35 (agreement 92%, 95% confidence interval [95% CI] 85.8-95.7%, kappa = 0.78; sensitivity 96.6%, 95% CI 80.4-99.8; specificity 90.7%, 95% CI 83.2-95.2) and for DeltaPMR-AS scores > or =6.6 (agreement 98%, 95% CI 88.0-99.9%, kappa = 0.95; sensitivity 100%, 95% CI 74.7-100; specificity 97.1%, 95% CI 82.9-99.8). Other parameters showed weaker diagnostic performance. CONCLUSION: This study supplies new evidence that the PMR-AS is useful for monitoring PMR activity in everyday practice and for managing glucocorticoid tapering. PMR activity changes seem even more relevant than absolute values.
OBJECTIVE: To evaluate the effectiveness of the polymyalgia rheumatica activity score (PMR-AS) in diagnosing disease flares. METHODS: Rheumatologists prospectively included 89 patients with PMR (mean +/- SD age 74.6 +/- 6.2 years, mean +/- SD disease duration 1.6 +/- 2.2 years). At each visit, the rheumatologist assessed disease activity using a visual analog scale (VAS) and recorded whether a disease flare was diagnosed and/or the glucocorticoid dose changed. Overall, 137 visits including 49 pairs (allowing intraindividual comparisons) were available; a disease flare was diagnosed at 32 visits. We evaluated statistical associations linking flare diagnosis to the PMR-AS, each of its components (VAS, VAS for pain, C-reactive protein, morning stiffness, and elevation of upper limbs), and changes in these parameters between 2 visits. RESULTS: Associations with disease flare diagnosis were strongest for PMR-AS scores > or =9.35 (agreement 92%, 95% confidence interval [95% CI] 85.8-95.7%, kappa = 0.78; sensitivity 96.6%, 95% CI 80.4-99.8; specificity 90.7%, 95% CI 83.2-95.2) and for DeltaPMR-AS scores > or =6.6 (agreement 98%, 95% CI 88.0-99.9%, kappa = 0.95; sensitivity 100%, 95% CI 74.7-100; specificity 97.1%, 95% CI 82.9-99.8). Other parameters showed weaker diagnostic performance. CONCLUSION: This study supplies new evidence that the PMR-AS is useful for monitoring PMR activity in everyday practice and for managing glucocorticoid tapering. PMR activity changes seem even more relevant than absolute values.
Authors: Izzat Shbeeb; Divya Challah; Shafay Raheel; Cynthia S Crowson; Eric L Matteson Journal: Arthritis Care Res (Hoboken) Date: 2018-02-22 Impact factor: 4.794
Authors: Christian Dejaco; Christina Duftner; Marco A Cimmino; Bhaskar Dasgupta; Carlo Salvarani; Cynthia S Crowson; Hilal Maradit-Kremers; Andrew Hutchings; Eric L Matteson; Michael Schirmer Journal: Ann Rheum Dis Date: 2010-11-19 Impact factor: 19.103
Authors: Diane E Marsman; Thomas E Bolhuis; Nathan den Broeder; Alfons A den Broeder; Aatke van der Maas Journal: Trials Date: 2022-04-15 Impact factor: 2.728
Authors: Thomas E Bolhuis; Diane Marsman; Frank H J van den Hoogen; Alfons A den Broeder; Nathan den Broeder; Aatke van der Maas Journal: BMC Rheumatol Date: 2022-08-02