Incidence of diagnosed polymyalgia rheumatica and temporal arteritis in the United Kingdom, 1990-2001

Smeeth, Liam; Cook, Claire; Hall, Andrew J.

doi:10.1136/ard.2005.046912

Cited by 266 publications

(193 citation statements)

References 25 publications

(20 reference statements)

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“…W from a rheumatology specialist, we only included those with a PMR diagnosis and evidence of meeting the classification criteria [3] for PMR namely bilateral pain and stiffness in the hips and shoulders and elevated inflammatory markers. It was surprising that more men than women were recruited given that the quoted incidence ratio is 2:1 female to male [1] but, whilst we acknowledge that there are gender differences in the way patients experience chronic illnesses eg. in stress and the main findings.…”

Section: Strengths and Limitationsmentioning

confidence: 98%

“…Although weakness is not a widely accepted symptom of PMR, and is not part of the recent classification criteria, [1] several patients used the term. In most cases, with greater elaboration, it became clear that the term weakness was being used to describe limited function due to pain or stiffness.…”

Section: It Was Aching All Down My Back and I Just Fel I I Like Imentioning

confidence: 99%

“…Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatic condition in people aged over 50 with an incidence of 1 in 1000 in this age group and a lifetime risk of 2.4% for women and 1.7% for men [1,2]. It is characterised by pain and stiffness in the hips and shoulders, raised inflammatory markers and response to glucocorticosteroids, although atypical presentations can occur in up to 20% of those affected [3,4].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

“I suddenly felt I’d aged”: A qualitative study of patient experiences of polymyalgia rheumatica (PMR)

Twohig

Mitchell

Mallen

et al. 2015

Patient Education and Counseling

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Section: Strengths and Limitationsmentioning

confidence: 98%

Section: It Was Aching All Down My Back and I Just Fel I I Like Imentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

“I suddenly felt I’d aged”: A qualitative study of patient experiences of polymyalgia rheumatica (PMR)

Twohig

Mitchell

Mallen

et al. 2015

Patient Education and Counseling

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“…In the UK, the age-adjusted incidence of diagnosed PMR increased by 35% between 1990 and 2001 (from 6.9 to 9.3 per 10,000 person-years) (1). Patients with PMR are rarely referred to secondary care (1) and PMR is a common indication for long-term steroid use in the community (2).…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes, quality of life, and diagnostic uncertainty in the first year of polymyalgia rheumatica

Hutchings¹,

Hollywood²,

Lamping³

et al. 2007

Arthritis & Rheumatism

123

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Objective. To evaluate the impact of polymyalgia rheumatica (PMR) on clinical outcomes and quality of life (QOL); the relationship between laboratory measures and clinical outcomes, and changes in QOL; and agreement between rheumatologists in confirming the initial diagnosis. Methods. We conducted a prospective study of 129 participants in 8 hospitals in England who met a modified version of the Jones and Hazleman criteria and had not started steroid therapy. The main outcome measures were response to steroids after 3 weeks (minimum 50% improvement in proximal pain, morning stiffness <30 minutes, acute-phase response not elevated), relapses, QOL as measured by the Short Form 36 and Health Assessment Questionnaire, and diagnosis reassessment at 1 year. Results. At 3 weeks, 55% of participants failed to meet our definition of a complete response to steroid therapy. Both physical and mental QOL at presentation were substantially lower than general population norms and improved by 12.6 (95% confidence interval [95% CI] 10.8, 14.4) and 11.2 (95% CI 8.5, 13.8) points, respectively, at 1 year. Proximal pain and longer morning stiffness were significantly associated with lower physical QOL during followup, whereas erythrocyte sedimentation rate was most strongly associated with lower mental QOL during followup. There was moderate agreement between clinicians in confirming the PMR diagnosis (kappa coefficients 0.49 -0.65). Conclusion. PMR is a heterogeneous disease with a major impact on QOL. Ongoing monitoring should include disease activity based on symptoms, emergence of alternative diagnoses, and early referral of atypical and severe cases.

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“…To improve the accuracy of the PMR diagnosis, a more stringent definition of PMR was applied using the method that Smeeth et al used in their PMR study in the General Practice Research Database (11). In addition to a PMR Read code, those with PMR were required to have at least two prescriptions for oral corticosteroids in the 6 months following their PMR diagnosis.…”

Section: Sensitivity Analysismentioning

confidence: 99%

Fatigue as a precursor to polymyalgia rheumatica: an explorative retrospective cohort study

Green

Müller

Mallen

et al. 2014

Scandinavian Journal of Rheumatology

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Objectives: Polymyalgia rheumatica (PMR) is the commonest inflammatory disorder of older adults. Although not part of the recently published classification criteria, patients with PMR frequently complain of fatigue. We compared consultation for fatigue and sleep problems between individuals with and without PMR. Method: Consulters receiving a Read-coded diagnosis of PMR at nine general practices between 2000 and 2009 were matched by age, gender, general practice, and year of consultation to four patients without PMR. Fatigue and sleep problems were defined using Read codes. Cox regression was used to determine the association between PMR diagnosis and consultation for a fatigue/sleep problem. Results: In total, 549 PMR patients were identified. Their mean (SD) age was 73.9 (8.6) years and 71% of the participants were female. Prior to the index date, 33 PMR patients and 80 matched non-PMR patients consulted with fatigue (0.43 vs. 0.25 consultations per 10 000 person-years, p ¼ 0.006). PMR was associated with significantly more multiple fatigue consultations in the 12 months before PMR diagnosis [hazard ratio (HR) 1.95, 95% confidence interval (CI) 1.23-3.08]; no significant difference was seen in rates of consultations for sleep problems between patients with and without PMR. Conclusions: PMR patients were significantly more likely to have had multiple fatigue consultations before being diagnosed with PMR. Given the overproduction of inflammatory cytokines seen in PMR, this fatigue may represent a prodromal phase prior to consulting with more classical musculoskeletal symptoms. This suggests that clinicians should consider PMR as a potential diagnosis in older patients consulting with fatigue.

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Incidence of diagnosed polymyalgia rheumatica and temporal arteritis in the United Kingdom, 1990-2001

Cited by 266 publications

References 25 publications

“I suddenly felt I’d aged”: A qualitative study of patient experiences of polymyalgia rheumatica (PMR)

“I suddenly felt I’d aged”: A qualitative study of patient experiences of polymyalgia rheumatica (PMR)

Clinical outcomes, quality of life, and diagnostic uncertainty in the first year of polymyalgia rheumatica

Fatigue as a precursor to polymyalgia rheumatica: an explorative retrospective cohort study

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