PT  - JOURNAL ARTICLE
AU  - CAROLINE CLEUZIOU
AU  - AYMERIC BINARD
AU  - MICHEL DE BANDT
AU  - JEAN-MARIE BERTHELOT
AU  - ALAIN SARAUX
TI  - Contribution of the Polymyalgia Rheumatica Activity Score to Glucocorticoid Dosage Adjustment in Everyday Practice
AID  - 10.3899/jrheum.110866
DP  - 2012 Feb 01
TA  - The Journal of Rheumatology
PG  - 310--313
VI  - 39
IP  - 2
4099  - http://www.jrheum.org/content/39/2/310.short
4100  - http://www.jrheum.org/content/39/2/310.full
SO  - J Rheumatol2012 Feb 01; 39
AB  - 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 &amp;lt; 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 &amp;lt; 5 mg in 4 patients. When PMR-AS was &amp;lt; 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.