Background/Purpose: To date the longitudinal outcomes of those with isolated Polymyalgia Rheumatica (PMR) are poorly understood, owing largely to the fact that in the majority of countries PMR is diagnosed and managed in primary care, with only a minority of cases referred for specialist evaluation.

The aim of our study, was therefore to establish for the first time the longitudinal outcomes of an Irish population with isolated PMR.  

Methods: Patients were recruited to this multicentre longitudinal cohort study from a newly established fast track PMR clinic, where those fulfilling the 2012 EULAR/ ACR Provisional PMR classification criteria were invited to participate. Those with symptoms or imaging confirmation of  cGCA/ LV-GCA were excluded. Those who had 12 month follow-up were included in the final analysis. The statistical analysis was performed using STATA MP Version 18. P values < 0.05 are considered statistically significant.

Results: A total of 65 patients, including 33 (50.8%)  females,  were recruited. Mean age at the time of diagnosis was 70.44 (SD 7.15). There was one death, and three subsequent cancer diagnoses and these were excluded from the final analysis.

At one year, 23/61 (27.7%) patients remained on glucocorticoid therapy, with a mean dose of 3.282 (SD 2.038). A total of 13/61 (21.3%) were commenced on steroid sparing therapy – tocilizumab.

There was a total of 33 disease relapses, in 20 /61 patients (32.7%). 12 patients experienced 2 or more relapses. The mean time to disease relapse was 6.55 (3.69) months, with a mean steroid dose at the time of relapse of 6.652 (SD 4.168). Increased duration of early morning stiffness (p=0.04), and higher PMR-AS (p=0.05) at disease presentation were significantly associated with disease relapse. 2 osteoporotic fractures, 1 Achilles tendon rupture, 11 Lower respiratory tract infections – 4 of which required hospital admission, 1 episode of shingles, 2 cases of diabetes mellitus, 1 transient Ischaemic attack, 2 non-ST elevation myocardial infarctions , 10 cases of mood disturbance, and 2 cases of sleep disturbance were reported.

Conclusion: This prospective study reports for the first time the longitudinal outcomes of an Irish PMR population, and emphasises both the disease and management burden. These findings also highlight the importance of specialist input in the care of those with isolated PMR. 

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/one-year-outcomes-in-those-with-isolated-pmr-recruited-via-a-fast-track-pmr-clinic/