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Research ArticleArticle

Contribution of the Polymyalgia Rheumatica Activity Score to Glucocorticoid Dosage Adjustment in Everyday Practice

Caroline Cleuziou, Aymeric Binard, Michel De Bandt, Jean-Marie Berthelot and Alain Saraux
The Journal of Rheumatology December 2011, jrheum.110866; DOI: https://doi.org/10.3899/jrheum.110866
Caroline Cleuziou
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Aymeric Binard
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Michel De Bandt
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Jean-Marie Berthelot
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Alain Saraux
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Abstract

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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The Journal of Rheumatology
Vol. 50, Issue 1
1 Jan 2023
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Contribution of the Polymyalgia Rheumatica Activity Score to Glucocorticoid Dosage Adjustment in Everyday Practice
Caroline Cleuziou, Aymeric Binard, Michel De Bandt, Jean-Marie Berthelot, Alain Saraux
The Journal of Rheumatology Dec 2011, jrheum.110866; DOI: 10.3899/jrheum.110866

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Contribution of the Polymyalgia Rheumatica Activity Score to Glucocorticoid Dosage Adjustment in Everyday Practice
Caroline Cleuziou, Aymeric Binard, Michel De Bandt, Jean-Marie Berthelot, Alain Saraux
The Journal of Rheumatology Dec 2011, jrheum.110866; DOI: 10.3899/jrheum.110866
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