The OMERACT Core Domain Set for Outcome Measures for Clinical Trials in Polymyalgia Rheumatica

McDermott, Michael; Twohig, Helen; Neill, Lorna; Harrison, Eileen; Shea, Beverley; Black, Robert; Kermani, Tanaz A.; Merkel, Peter A.; Mallen, Christian; Buttgereit, Frank; Mukhtyar, Chetan; Simon, Lee S.; Hill, Catherine

doi:10.3899/jrheum.161109

Cited by 35 publications

(28 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thresholds to define relapse have been proposed 43 , but these measures are not widely used in clinical practice and trials. An OMERACT study group for PMR identified systemic inflammation (detected via laboratory markers), physical function, pain and stiffness as core outcomes that should be evaluated in all clinical trials and should be incorporated into a new score for assessing PMR disease activity 44 .…”

Section: Clinical Monitoringmentioning

confidence: 99%

Monitoring and long-term management of giant cell arteritis and polymyalgia rheumatica

et al. 2020

Self Cite

View full text Add to dashboard Cite

Giant cell arteritis (GCA) is the most common type of primary vasculitis in Western countries 1,2. Polymyalgia rheumatica (PMR) is the second most common inflammatory rheumatic disease of the elderly after rheumatoid arthritis (RA) 3. The two diseases are interrelated: 40-60% of patients with GCA have symptoms of PMR 3 , and histological features consistent with GCA have been found in 16-21% of temporal artery biopsy samples from patients with PMR 3. Most of these patients with PMR, however, presented with additional features of GCA, whereas the prevalence of positive histology in unselected patients with PMR is unknown. Both GCA and PMR are heterogeneous diseases. Although systemic manifestations (such as fever, malaise and weight loss) are common in both diseases, they are not present in all patients 4-6. Up to 1 in 5 patients with GCA with ocular involvement can present without systemic manifestations of the disease 7. GCA is the most common form of large-vessel vasculitis (LVV) and has a broad spectrum of disease manifestations, which are frequently overlapping. In the majority of cases, cranial and extracranial large arteries are involved to varying degrees, leading to different clinical phenotypes 8,9. Isolated cranial or extracranial GCA, which are at either end of this continuum, are relatively uncommon 10. Predominant cranial GCA is characterized by headache, jaw claudication and visual manifestations (representing the prototypical clinical picture of temporal arteritis). By contrast, predominant large-vessel GCA is characterized by more pronounced systemic manifestations, PMR, vascular bruits, limb claudication and imaging signs of inflammation in the aorta and its major branches 10. In some of these patients, vascular stenoses or aneurysms in association with other GCA features are the presenting clinical manifestations 9,11. PMR is characterized by pain and stiffness in the shoulder and pelvic girdles, which can have an abrupt or a subtle onset 3. Up to 20% of patients with PMR can present with a normal erythrocyte sedimentation rate (ESR) 12 , although the presence of both normal ESR and C-reactive protein (CRP) levels is rare 13-15. Glucocorticoids are the cornerstone of treatment for GCA and PMR. They are effective, but glucocorticoidrelated adverse effects occur in up to 85% of patients with GCA and 65% of patients with PMR, respectively 16-22. The IL-6 receptor inhibitor tocilizumab has become available as a glucocorticoid-sparing strategy in patients with GCA 23,24 , an approach that is also being evaluated for PMR 25,26. Management of both GCA and PMR is hampered by the lack of universally accepted definitions of remission and other disease states (such as low disease activity or vessel damage without active disease). Many questions about monitoring and long-term management are still unanswered (Box 1).

show abstract

Section: Clinical Monitoringmentioning

confidence: 99%

Monitoring and long-term management of giant cell arteritis and polymyalgia rheumatica

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Besides, higher percentage of patients relapsed during the reduction of glucocorticoid among those with PMR, while more patients had infections due to immune suppression treatment among those without PMR. Therefore, it is necessary to highlight the importance of follow-up and integrated management of GCA patients, and the reasons for poor prognosis in some GCA patients should be examined [29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Differences in clinical manifestations and prognosis of Chinese giant cell arteritis patients with or without polymyalgia rheumatica

et al. 2018

View full text Add to dashboard Cite

Background The symptoms of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) frequently overlap in the elderly. Whether there are differences in clinical features or prognosis between GCA patients with or without PMR remains unknown. Aims To identify differences in clinical manifestation and prognosis between Chinese GCA patients with or without PMR. Methods A retrospective study of patients diagnosed with GCA in Peking Union Medical College Hospital (PUMCH) during the last 20 years was conducted. Clinical data was collected and analyzed accordingly, and follow-up was performed. Results A total of 50 patients had PMR, while 41 patients did not, with no significant differences in age, gender, and disease course between the two groups. GCA patients with PMR presented with higher risks of family history of malignancy (p = 0.048). Patients without PMR had higher proportion of hearing loss (p = 0.006), ANCA positive (p = 0.024), and abnormal imaging findings illustrating the involvement of arteries under aortic arch (p = 0.018). Before treatment, total lymphocyte counts in patients without PMR were lower than those with PMR, and monocyte counts in both groups were higher than normal. Acute phase reactants in patients without PMR were higher than the other group. No significant differences were found in prognosis during follow-up. Conclusions GCA patients with or without PMR have different clinical characteristics. Patients with PMR present myalgia or arthralgia more frequently, while those without PMR have higher inflammatory markers, lower lymphocyte counts, and wider involvement of arteries under aortic arch.

show abstract

“…Since the Outcome Measures in Rheumatology (OMERACT) Filer 2.0 resulted in successful development and implementation of COSs for many other diseases, we used their methodology [16][17][18][19][20][21][22]. The OMERACT Filter is a conceptual framework which encompasses the entire content of what is measureable in a study.…”

Section: Methodsmentioning

confidence: 99%

European Society of Coloproctology Core Outcome Set for haemorrhoidal disease: an international Delphi study among healthcare professionals

et al. 2019

View full text Add to dashboard Cite

show abstract

The OMERACT Core Domain Set for Outcome Measures for Clinical Trials in Polymyalgia Rheumatica

Cited by 35 publications

References 18 publications

Monitoring and long-term management of giant cell arteritis and polymyalgia rheumatica

Monitoring and long-term management of giant cell arteritis and polymyalgia rheumatica

Differences in clinical manifestations and prognosis of Chinese giant cell arteritis patients with or without polymyalgia rheumatica

European Society of Coloproctology Core Outcome Set for haemorrhoidal disease: an international Delphi study among healthcare professionals

Contact Info

Product

Resources

About