Materiały źródłowe

• #1 Polymyalgia Rheumatica – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537274/

  Polymyalgia rheumatica (PMR) is a rheumatic disorder characterized by pain and stiffness around the neck, shoulder, and hip area. This disorder is more common in White adults older than 50 years of age. […] The annual incidence of PMR in individuals aged 50 years or older was found to be between 58 to 96 per 100,000 population, specifically predominantly White populations. Incidence rates increase with age until 80 years. […] PMR has been reported as the second most common inflammatory autoimmune rheumatic disease after rheumatoid arthritis in some predominantly White populations. It is at least twice as common as GCA and is found in approximately 50% of patients with GCA. PMR is much less common in Black, Asian, and Hispanic populations.

• #2 Polymyalgia Rheumatica (PMR): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/330815-overview

  In the United States, the average annual incidence of polymyalgia rheumatica (PMR) is 52.5 cases per 100,000 persons aged 50 years and older. The prevalence is approximately 0.5-0.7%. In a Mayo Clinic study from 2000-2014, the overall age- and sex-adjusted annual incidence of PMR was 63.9 per 100,000 population aged 50 years; the incidence rate was slightly higher in those years, compared with 1970-1999. […] Worldwide, the frequency varies by country. In Europe, the frequency decreases from north to south, with a high incidence in Scandinavia and a low incidence in Mediterranean countries. In Italy, for example, the incidence is 12.7 cases per 100,000 persons. A United Kingdom study found an overall incidence rate of 95.9 cases per 100 000 population. […] In a systematic review of case records from a large primary care practice in the UK, the prevalence of PMR in patients age 55 years and older ranged from 0.91% to 1.53%, depending on the criteria set used for diagnosis. […] Whites are affected more than other ethnic groups. PMR is only occasionally reported in Blacks. PMR is twice as common in women. […] The incidence increases with advanced age. PMR rarely affects persons younger than 50 years. The median age at diagnosis is 72 years.

• #3 Polymyalgia rheumatica (musculoskeletal manifestations) | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/polymyalgia-rheumatica-musculoskeletal-manifestations?lang=us

  Polymyalgia rheumatica is the most common inflammatory rheumatic condition in older adults 1. […] Treatment is usually low dose corticosteroids which most patients respond well to 1.

• #4 Polymyalgia Rheumatica | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/27416

  Polymyalgia rheumatica (PMR) is a rheumatic disorder characterized by pain and stiffness around the neck, shoulder, and hip area that significantly impacts quality of life. This disorder is more common in white adults over 50 years of age. […] The annual incidence of PMR in individuals aged 50 years or older was found to be between 58 to 96 per 100,000 population, specifically predominantly White populations. Incidence rates increase with age until 80 years. […] PMR has been reported as the second most common inflammatory autoimmune rheumatic disease after rheumatoid arthritis in some predominantly White populations. It is at least twice as common as GCA and is found in approximately 50% of patients with GCA. […] PMR is much less common in Black, Asian, and Hispanic populations.

• #5 Epidemiology of Polymyalgia Rheumatica 2000-2014 and Examination of Incidence and Survival Trends over 45 Years: A Population Based Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5400734/

  To determine time trends in the incidence and survival of polymyalgia rheumatica (PMR) over a 15 year period in Olmsted County, Minnesota, USA and to examine trends in incidence of PMR in the population by comparing this time period to a previous incidence cohort from the same population base. […] There were 377 incident cases of PMR during the 15 year study period. Of these 64% were female and the mean age at incidence was 74.1 years. The overall age and sex adjusted annual incidence of PMR was 63.9 (95% confidence interval [CI] 57.4, 70.4) per 100,000 population aged 50 years. […] The incidence of PMR has increased slightly in the past 15 years compared to previous decades. Survivorship in patients with PMR is not worse than in the general population. […] The incidence of PMR in Olmsted County from 1970 to 1999 was 59/100,000, with survivorship similar to the general population.

• #6 Epidemiology of Polymyalgia Rheumatica 2000-2014 and Examination of Incidence and Survival Trends over 45 Years: A Population Based Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5400734/

  The age and sex adjusted annual incidence rate of PMR in 2000-2014 was 63.9 (95% CI 57.4, 70.4) per 100,000 population aged 50 years and older. […] The incidence of PMR in this long-term study demonstrates variability at specific time points with a slight overall increase in incidence over the past 45 years. […] The annual incidence of PMR in Olmsted County is 63.9/100,000 population for the years 2000-2014. This compares to an average incidence rate of 58.7/100,000 in this population for 1975-1999. […] Using the same case ascertainment procedures for PMR from 1970 to 2014, the incidence of PMR has increased slightly in the last 15 years. […] In conclusion, the incidence of PMR has increased somewhat over the past 45 years. Survival among patients with PMR is not worse than the general population.

• #7 Polymyalgia Rheumatica Market Size 2024-2034

  https://www.imarcgroup.com/polymyalgia-rheumatica-market

  The rising prevalence of several risk factors, such as genetic predisposition, chronic infections, environmental aspects, etc., is primarily driving the polymyalgia rheumatica market. […] In the United States, the average yearly incidence of this illness is 52.5 cases per 100,000 people aged 50 and above. […] The prevalence is about 0.5-0.7 percent. […] In Europe, the frequency declines from north to south, with a high incidence in Scandinavia and a low level of incidence in Mediterranean countries. […] A United Kingdom study reported an overall incidence rate of 95.9 incidents per 100,000 people. […] White people are more affected than other ethnic groupings. polymyalgia rheumatica is only rarely observed among Blacks. […] Polymyalgia rheumatica is twice as prevalent in women.

• #8 Polymyalgia Rheumatica: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/polymyalgia-rheumatica-pro

  The annual incidence of the disease in the general population in the UK has been estimated as 95 per 100,000. […] Globally, the incidence is thought to be between 58 to 96 per 100,000. […] PMR occurs almost exclusively in people aged above 50 and the mean age of onset is about 73. […] Lifetime risk is around 2.4% for women and 1.7% for men. […] PMR is seen mainly in people of north European ancestry, although it can occur in any ethnic group.

• #9 Polymyalgia Rheumatica and Giant Cell Arteritis: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1000/polymyalgia-rheumatica-giant-cell-arteritis.html

  Polymyalgia rheumatica and giant cell arteritis are inflammatory conditions that occur predominantly in people 50 years and older, with peak incidence at 70 to 75 years of age. […] Incidences of PMR and GCA vary among people 50 years and older depending on geographic location. The incidence per 100,000 people 50 years and older ranges from 2 (Korea) to 113 (Norway) for PMR and 1 (Turkey) to 44 (Iceland) for GCA. […] Approximately 20% of patients with PMR have GCA, and about 50% of patients with GCA have PMR. […] Risk factors for PMR and GCA include female sex, Northern European ancestry, and age. […] The age of onset for both conditions is typically 50 years and older, with peak incidence at 70 to 75 years of age.

• #10 Polymyalgia Rheumatica (17.06.2022)

  https://di.aerzteblatt.de/int/archive/article/225760

  Polymyalgia rheumatica (PMR) is among the most common inflammatory rheumatic diseases in older adults. Presumed risk factors include female sex, previous infections, and genetic factors. No epidemiological data on PMR in Germany have been available until now. […] The annual age- and sex-standardized incidence and prevalence of PMR from 2011 to 2019 were 18.6/100 000 persons and 138.8/100 000 persons, respectively. The incidence was higher in women than in men (21.8/100 000 vs. 12.8/100 000 persons per year). […] During the period 2011-2019, 24,194 persons in the age group 40 years who were insured with the AOK Baden-Württemberg developed PMR. The mean age-standardized annual incidence of PMR was 17.7/100 000 insured persons aged 40 years. […] Incidence rates of PMR differ markedly depending on the origin of the study population, as is shown by comparisons with data from other countries. Individuals of northern European descent are more commonly affected by PMR than those from southern Europe.

• #11 Polymyalgia Rheumatica (17.06.2022)

  https://di.aerzteblatt.de/int/archive/article/225760

  Mean annual age- and sex-standardized prevalence in the period 2011-2019 was 129.8/100 000 insured persons. The prevalence was observed to increase during this period. In 2011 it was 107.2/100 000 insured persons, whereas it had increased to 145.1/100 000 insured persons by 2019. […] Women are more commonly affected by PMR than men, with the sex ratio varying between 2:1 and 3:1 in the literature. The lifetime risk of developing PMR is 2.4% for women and 1.7% for men. The mean age-standardized incidence of PMR was significantly higher in women than in men (21.8/100 000 versus 13.1/100 000 insured persons), and the prevalence of PMR also proved to be higher in women. […] This analysis of health insurance data shows that, in Germany as elsewhere, PMR predominantly affects women and is mainly diagnosed by the general practitioner. Further studies are needed to improve the health care of patients with PMR and to better understand the sex-specific differences in this disease.

• #12 AB1055 Epidemiology of Polymyalgia Rheumatica in South Korea | Annals of the Rheumatic Diseases

  https://ard.bmj.com/content/73/Suppl_2/1149.2

  Polymyalgia rheumatica (PMR) is a chronic inflammatory disease affecting people older than 50 years. Diagnosis is made based on clinical features and the current standard of treatment is low-dose glucocorticoids. PMR is known to be more frequent in Caucasian ethnicity and females. But up to date, there has been a scant epidemiologic study of PMR in Asian countries including Korea. […] We aimed to estimate incidence and prevalence rates of PMR and current treatment state in Korea. […] We identified total 1,463 newly diagnosed cases of PMR for the 5 years. The annual incidence rate of PMR per 100,000 Korean individuals was estimated as 2.06 (1.45 in male, 2.59 in female), and the prevalence rate was 8.21 per 100,000 individuals in 2012 (5.60 in male, 10.42 in female). Among the 1,463 cases, 992 (67.8%) were female and 471 (32.2%) were male and the median age at the time of diagnosis was 67 years old. The incidence rate according to age appeared to increase with advancing age peaking 70 years old, as similar as previous reports of western studies.

• #13 AB1055 Epidemiology of Polymyalgia Rheumatica in South Korea | Annals of the Rheumatic Diseases

  https://ard.bmj.com/content/73/Suppl_2/1149.2

  This is the first study that evaluated epidemiologic data of PMR in Korea, and included population was the largest among those of studies published in East Asia so far. The incidence and prevalence rates of PMR are estimated considerably lower than that of Western populations. And this result supports that both genetic and environmental factor would play important roles in pathogenesis of PMR.

• #14 Epidemiology of Polymyalgia Rheumatica in Korea

  https://www.jrd.or.kr/journal/view.html?uid=1053&vmd=Full

  Epidemiology of Polymyalgia Rheumatica in Korea […] Objective. Polymyalgia rheumatica is a chronic inflammatory disease that affects people older than 50 years of age. The diagnosis is made based on clinical features, and the current standard of treatment is low-dose glucocorticoids. PMR is more commonly reported in Caucasians and females. However, epidemiological studies of PMR in Asian countries are scarce. We aimed to estimate the epidemiology of PMR in Korea. […] Methods. This study was conducted by analyzing the Health Insurance Review and Assessment databases. We verified all claims between 2007 and 2012. Cases were included when PMR ICD-10 code (M 35.3) was recorded more than twice, and glucocorticoids were prescribed for ≥30 days. […] Results. We identified 1,463 newly diagnosed cases of PMR during the 5 years. Among them, 992 (67.8%) were female, and the mean age at diagnosis was 66.9 years old. The annual incidence rate was 2.06 per 100,000 individuals aged over 50 years. The prevalence rate was 8.21 per 100,000 individuals in 2012. Incidence and prevalence appeared to increase with age. Prednisolone was the most commonly prescribed glucocorticoid. In half of the patients, the daily starting dose was 6~15 mg as prednisolone equivalents.

• #15 Epidemiology of Polymyalgia Rheumatica in Korea

  https://www.jrd.or.kr/journal/view.html?uid=1053&vmd=Full

  Conclusion. This is the first study to investigate the epidemiology of PMR in Korea. The incidence and prevalence appeared to be considerably lower than those in Western populations. Both genetic and environmental factors might influence disease occurrence. In addition, the actual incidence may have been underestimated due to lack of awareness of PMR in clinical practice. […] Keywords: Polymyalgia rheumatica, Epidemiology, Korea

• #16 Polymyalgia rheumatica epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Polymyalgia_rheumatica_epidemiology_and_demographics

  Polymyalgia rheumatica (PMR) affects mostly subjects who are more than 50 years of age. The prevalence of PMR is highest among subjects from Scandanavian countries and those from northern European origin. […] The annual incidence of PMR is 64 per 100,000 population ages 50 years. […] PMR affects more than 700,000 subjects in the United States. […] Mortality rate among individuals with PMR is similar to the general population. […] The incidence of polymyalgia rheumatica increases with age. PMR mostly affects people who are older than 50 years of age. The mean age for the occurrence of PMR is 74 years. […] Polymyalgia rheumatica occurs more among subjects from Scandinavian countries and those from northern European origin. […] Females are more affected with polymyalgia rheumatica than men.

• #17 Polymyalgia rheumatica – Wikipedia

  https://en.wikipedia.org/wiki/Polymyalgia_rheumatica

  Polymyalgia rheumatica is a systemic inflammatory disease characterized by pain or stiffness, usually in the neck, shoulders, upper arms, and hips, but which may occur all over the body. Almost all cases occur in people age 50 or older. […] The average age of a person who has PMR is about 70 years old, with the highest prevalence in those older than 70. […] Women are three times as likely to get PMR as men. […] People of Western and Northern European descent are more likely to get this disease. It is more likely to affect people of Northern European origin; Scandinavians are especially vulnerable. […] About 50% of people with temporal arteritis also have polymyalgia rheumatica.

• #18 Adverse Effects in Patients with Polymyalgia Rheumatica | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0601/p2832a.html

  Polymyalgia rheumatica is a disease characterized by pain and stiffness in the proximal regions of the extremities and the trunk. It tends to occur in middle-aged and elderly persons who often experience pain and stiffness for a month or longer before diagnosis. […] The authors reviewed an extensive database of patients who were part of the Rochester (Minn.) Epidemiology Project and identified all patients diagnosed with polymyalgia rheumatica between 1970 and 1991. […] The mean age at diagnosis of polymyalgia rheumatica was 72.9 years, and the average follow-up time was eight years. […] The risks of diabetes, vertebral fracture, femoral neck fracture and hip fracture were two to five times greater in patients with polymyalgia rheumatica than in age- and sex-matched control subjects from the same population. […] The authors conclude that although the duration of treatment for polymyalgia rheumatica is often short and the dosages of corticosteroids and NSAIDs used to treat this condition are low, there is a high incidence of adverse events, and they are associated with significant morbidity.

• #19 Frequency, Diagnosis, and Management of Polymyalgia Rheumatica in Germany – Database Analysis of Medical Insurance Data – ACR Meeting Abstracts

  https://acrabstracts.org/abstract/frequency-diagnosis-and-management-of-polymyalgia-rheumatica-in-germany-database-analysis-of-medical-insurance-data/

  Frequency, Diagnosis, and Management of Polymyalgia Rheumatica in Germany Database Analysis of Medical Insurance Data […] To date, there is limited data on the epidemiology of polymyalgia rheumatica (PMR) in Germany. National prevalence estimates suggest only 69,000 affected individuals, which would be low by international standards. This analysis presents up-to-date data representative of Germany. […] A cross-sectional analysis was conducted on a sample of 4.8 million insured individuals, representative of the German population, from the InGef (Institute for Health Research Berlin GmbH) research database, containing anonymized longitudinal data from over 60 statutory health insurances. […] Each year from 2018 to 2021, 1.7 million insured individuals met the inclusion and exclusion criteria. The mean age of incident patients was 71.8 years, and prevalent patients were 75.3 years old. 58.0% of incident and 62.7% of prevalent patients were female. Diagnosis was made predominantly in outpatient settings (88%), most commonly by general practitioners (61%), rheumatologists (10%), and orthopedists (8%). […] Contrary to previous beliefs, Germany has one of the highest incidences and prevalences of PMR. Diagnosis primarily occurs in general practice settings, with about one-third of patients being treated by rheumatologists. Comorbidities such as diabetes or cardiovascular diseases are common.

• #20 Polymyalgia rheumatica – Symptoms, Causes, Images, and Treatment Options

  https://www.epocrates.com/online/diseases/153/polymyalgia-rheumatica

  Polymyalgia rheumatica (PMR) is an inflammatory rheumatologic syndrome. Affected patients describe difficulty rising from seated or prone positions, significant shoulder and hip girdle stiffness, varying degrees of muscle tenderness, shoulder/hip bursitis, and/or oligoarthritis. […] More common in women. […] About 15% to 20% of patients with PMR have giant cell arteritis (GCA); 40% to 60% of GCA patients have PMR. […] Epidemiology of polymyalgia rheumatica 2000-2014 and examination of incidence and survival trends over 45 years: A population-based study. […] Epidemiology of polymyalgia rheumatica. […] Epidemiology of giant cell arteritis and polymyalgia rheumatica. […] Epidemiology of polymyalgia rheumatica in Olmstead County, Minnesota, 1970-1991. […] Trends in the incidence of polymyalgia rheumatica over a 30 year period in Olmsted County, Minnesota, USA. […] Mortality among patients with polymyalgia rheumatica: A retrospective cohort study. […] Risk of vascular events in patients with polymyalgia rheumatica.

• #21 Polymyalgia Rheumatica – Vasculitis Foundation

  https://vasculitisfoundation.org/education/vasculitis-types/polymyalgia-rheumatica/

  Polymyalgia rheumatica (PMR) is a rare inflammatory disease that affects older adults, causing widespread muscle pain and stiffness, especially around the shoulders and hips. Most people who develop PMR are in their 60s or 70s. PMR is closely linked with giant cell arteritis (GCA), a type of vasculitis characterized by inflammation of the arteries in the head (temples) and of the aorta, resulting in headaches and vision problems. Left untreated, GCA can lead to blindness and stroke. The two diseases can occur at the same time in the same person. Approximately 15 percent to 20 percent of people with PMR will develop GCA, while about half of patients with GCA also have symptoms of PMR. […] In the United States, disease prevalence is estimated at 50 people per 100,000 per year, and it affects Caucasians more than any other ethnic group. Internationally, prevalence varies country by country. People of Northern European and Scandinavian descent have the highest risk of getting the disease. […] 10% of individuals diagnosed with PMR will eventually develop features of GCA. 1:04 20-30% of patients initially diagnosed with GCA will features of PMR. 1:17 Epidemiology of PMR.

• #22 Polymyalgia rheumatica: An updated review | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/549

  PMR typically presents in people over age 50, with incidence increasing with age. Annual incidence varies from 12 to 60 cases per 100,000 in different populations, with the highest rate in those of Northern European descent. Women are more often affected than men. […] PMR’s etiology is not well understood. Genetic and infectious associations have been investigated without conclusive results. Studies in various geographic regions have revealed increased numbers of certain polymorphisms for genes involved in the immune system, but they have not been consistently found across different populations of patients with PMR. […] GCA is diagnosed in 16% to 21% of patients with PMR, and between 35% and 50% of patients with GCA have coexisting PMR. A number of studies have explored genetic features that might link these diseases. Both are associated with certain genetic polymorphisms, particularly those related to the immune system, including genes for human leukocyte antigen and tumor necrosis factor (TNF). However, these associations have not been found consistently.

• #23 The spectrum of giant cell arteritis and polymyalgia rheumatica: a longitudinal prospective study to assess for subclinical giant cell arteritis in new onset polymyalgia rheumatica | Egyptian Rheumatology and Rehabilitation | Full Text

  https://erar.springeropen.com/articles/10.1186/s43166-025-00307-7

  Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) frequently overlap, with each disease potentially presenting as a manifestation of the other. The strong relationship between PMR and GCA raises the question of whether it is a co-occurrence of different diseases or a common spectrum of inflammatory diseases. The objectives of the current study were to assess the applicability of using ultrasound (US) and clinical data as a monitoring tool to identify PMR patients with subclinical GCA and determine possible predictors of GCA among PMR patients. […] The study found that 20.4% of the PMR cohort had subclinical GCA, which later progressed to classical GCA, while 31.5% experienced a PMR relapse. […] Routine screening for subclinical GCA in PMR patients should be considered as part of standard care for PMR patients.

• #24 Polymyalgia rheumatica – an up-to-date review on diagnosis and management

  https://www.oaepublish.com/articles/2574-1209.2023.137

  Giant cell arteritis (GCA) is the most common form of vasculitis affecting adults, with an incidence rate of approximately 10 per 100,000 in those over the age of 50 years. […] A reported 40%-60% of patients with GCA report symptoms of PMR, and 15%-20% of those with PMR have a concomitant GCA, either at disease onset or throughout the course of their disease. […] Due to this significant clinical overlap, in addition to the fact that both conditions occur solely in those 50 years of age and have an IL-6 signature with an excellent initial response to glucocorticoids, there is a move to recognise these conditions not as separate entities, but instead as different manifestations of a common, albeit complex spectrum. […] The current treatment paradigm of both GCA and PMR has glucocorticoids at the cornerstone, but the dose used to treat PMR is significantly lower than that used to treat GCA.

• #25 The spectrum of giant cell arteritis and polymyalgia rheumatica: a longitudinal prospective study to assess for subclinical giant cell arteritis in new onset polymyalgia rheumatica | Egyptian Rheumatology and Rehabilitation | Full Text

  https://erar.springeropen.com/articles/10.1186/s43166-025-00307-7

  The strong relationship between PMR and GCA raises the question of whether it is a co-occurrence of different diseases or a common spectrum of inflammatory diseases. This has important implications for the patients management, as the standard glucocorticoid dose for the management of PMR may not be effective in preventing serious GCA complications, particularly in those PMR patients with undetected subclinical GCA. […] The presence of intimal media thickening of the temporal artery or its branches/axillary artery at baseline, as well as the occurrence of cranial signs (temporal headaches, temporal artery abnormalities, scalp tenderness, jaw claudication, and/or visual disturbances) or constitutional symptoms at 2 months or later of the PMR onset, are predictors of GCA, which can then be confirmed by performing temporal artery biopsy and/or US. […] Results of this study demonstrated that baseline US assessment of temporal/axillary arteries with OGUS score above 1 portends a higher frequency of developing GCA; hence it can act as a very early predictor.

• #26

  https://reu.termedia.pl/Polymyalgia-rheumatica-and-cancer-the-surveillance-duration-and-other-points-to-ponder,156698,0,1.html

  Polymyalgia rheumatica (PMR) is one of the most common inflammatory rheumatic disease affecting the elderly. Up to 20% of patients with PMR may develop giant cell arteritis (GCA), a primary granulomatous vasculitis affecting the aorta and its branches. The association of PMR with GCA, also known as Hortons disease, has therapeutic and prognostic consequences. […] Polymyalgia rheumatica diagnosis is essentially clinical in the absence of a gold standard diagnostic text. Although studies from institutional databases typically include a large case series, diagnoses of the various diseases are based on coding and not always confirmed by individual medical record reviews. Therefore, registry-based studies may be at the risk of misdiagnosis/misclassification. On the other hand, cohort studies have much less data. Nonetheless, they can have higher diagnostic or classification accuracy, because these patients are carefully chosen to answer a specific research question. Finally, cohort-studies performed on hospitalized patients could favour an inclusion bias because it is uncommon for a patient with typical PMR to be hospitalized.

• #27

  https://reu.termedia.pl/Polymyalgia-rheumatica-and-cancer-the-surveillance-duration-and-other-points-to-ponder,156698,0,1.html

  A review published in 2018 found some evidence of a short-term association (i.e. between 6 and 12 months after diagnosis of PMR) between PMR and cancer. The authors suggested focussing on identifying PMR patients who are most likely to develop a cancer in the short-term. On the other hand, other researchers proposed that the minimum observation time should not be 24 months. Choosing the duration of the follow-up period for linking PMR to cancer is important in order to avoid arbitrary criteria. […] A confirmed positive association between PMR and cancer would imply that increased cancer screening in this population would be beneficial. Simple screening tests such as a chest X-ray, a prostate-specific antigen (PSA) or an ultrasound abdominal assessment may be warranted as part of the diagnostic work-up of PMR.

• #28

  https://reu.termedia.pl/Polymyalgia-rheumatica-and-cancer-the-surveillance-duration-and-other-points-to-ponder,156698,0,2.html

  A review published in 2018 found some evidence of a short-term association (i.e. between 6 and 12 months after diagnosis of PMR) between PMR and cancer. The authors suggested focussing on identifying PMR patients who are most likely to develop a cancer in the short-term. On the other hand, other researchers proposed that the minimum observation time should not be 24 months. Choosing the duration of the follow-up period for linking PMR to cancer is important in order to avoid arbitrary criteria. […] A confirmed positive association between PMR and cancer would imply that increased cancer screening in this population would be beneficial. Simple screening tests such as a chest X-ray, a prostate-specific antigen (PSA) or an ultrasound abdominal assessment may be warranted as part of the diagnostic work-up of PMR.

• #29 Norwegian society of rheumatology recommendations on diagnosis and treatment of patients with Polymyalgia Rheumatica: a narrative review | BMC Rheumatology | Full Text

  https://bmcrheumatol.biomedcentral.com/articles/10.1186/s41927-024-00422-6

  Polymyalgia rheumatica (PMR) is a common inflammatory rheumatic disease characterized by subacute onset of proximal muscle pain and stiffness in the neck, shoulders, pelvic girdle and elevated acute phase reactants. […] PMR occurs almost exclusively in people older than 50 years, with a peak between 70 and 79 years of age, and women are approximately 2 to 3 times more likely to be affected than men. […] The highest incidence of PMR has been reported in Nordic countries and among North-American people of Scandinavian descent. […] Recent studies indicate that implementing PMR fast-track clinics may decrease time from symptom onset to diagnosis, and reduce the number of hospital contacts and hospitalization days prior to PMR diagnosis. […] The guideline aims to provide evidence-based, up-to-date recommendations and harmonize the diagnostic and treatment procedures for PMR in the Norwegian Healthcare System.

• #30 Polymyalgia rheumatica – an up-to-date review on diagnosis and management

  https://www.oaepublish.com/articles/2574-1209.2023.137

  Consequently, it is imperative that all patients undergo a thorough evaluation including a careful history and comprehensive physical examination, in order to distinguish PMR from other conditions with similar features, which is arguably best done in specialist rheumatology clinics. […] A proposed method of optimising early diagnostic accuracy and, indeed, overall patient outcomes is the implementation of fast-track clinics. […] To date, only two studies have reported on the use of fast-track clinics in PMR, with both demonstrating that providing timely and easily accessible specialist care improves diagnosis and, indeed, patient outcomes. […] It is evident that PMR often proves a diagnostic challenge, and undeniably, one of the most significant unmet needs in its management is the lack of a disease-specific serum biomarker for diagnosis and disease prognostication.

• #31 Polymyalgia rheumatica – an up-to-date review on diagnosis and management

  https://www.oaepublish.com/articles/2574-1209.2023.137

  The long-term use of glucocorticoids is indeed a cause for concern, particularly in those with PMR, who are typically an older cohort of patients, for whom the well-recognised adverse effects of steroid therapy can be even more devastating. […] In order to aid steroid reduction in those with refractory or relapsing disease, a number of different glucocorticoid-sparing agents have been studied. […] The FDA approval of sarilumab for those with refractory PMR most certainly heralds a new era in the management of PMR.

• #32 Epidemiology of polymyalgia rheumatica and giant cell arteritis – White Rose eTheses Online

  https://etheses.whiterose.ac.uk/id/eprint/27690/

  Polymyalgia rheumatica and giant cell arteritis are two inflammatory disorders that are more common among female individuals with Scandinavian ancestry. The conditions co-occur in the same individual more often than expected by chance, share common symptoms and are difficult to diagnose. Cases with PMR and GCA were more likely to report a previous diagnosis of hypothyroidism, transient ischaemic attack and hypertension. Female cases with PMR were more likely to have ever received hormone replacement treatment and female cases with GCA to have an early menopause (43 years). GCA cases were found to have a strong association with HLA-DRB1*0401 and PMR cases with HLA-DRB1*0404. The estimated proportion of patients misdiagnosed as GCA was 67% in the negative-TAB group and 33% in the group without TAB result. Meta-analysis results reveal a novel association with rs148462291 in chromosome 3. Pair-wise analysis of PMR and GCA data suggest this variant is associated with both PMR and GCA. […] There was no evidence that shared genetic risk factors were due to subgroup heterogeneity within PMR cases, although this analysis lacked statistical power.

• #33 Risk Factors and Possible Causes of Polymyalgia Rheumatica

  https://www.arthritis-health.com/types/polymyalgia-rheumatica/risk-factors-and-possible-causes-polymyalgia-rheumatica

  Several risk factors are associated with polymyalgia rheumatica (PMR). The risk of PMR is known to increase with age. The condition is rarely seen in people under 50 years of age. Most cases involve people 75 years and older. Women are approximately 2 to 3 times more likely to be affected by PMR than men. People of any ethnicity can develop PMR. However, Caucasian people of northern European descent appear to be at a significantly higher risk. Not everyone with these risk factors will develop PMR. The presence of these risk factors only increases the likelihood of developing PMR. These same risk factors and possible causes are also seen in giant cell arteritis. Expert analysis indicates 40% to 60% of giant cell arteritis cases eventually develop PMR. There is also a 9% to 20% risk of PMR cases developing giant cell arteritis. Diagnostic tests of blood samples and genetic components reveal similar findings for PMR and giant cell arteritis, leading experts to see these conditions as two ends of the same disease spectrum.

• #34 Risk Factors and Possible Causes of Polymyalgia Rheumatica

  https://www.arthritis-health.com/types/polymyalgia-rheumatica/risk-factors-and-possible-causes-polymyalgia-rheumatica

  Several potential causes for PMR are being investigated. Some of the theories put forward by researchers include: Genetic predisposition. A specific gene called HLA-DR4 that is associated with rheumatoid arthritis is also present in many cases where PMR and giant cell arteritis occur together. Experts speculate this gene triggers the condition, although this is not a conclusive cause in PMR. Immunology. Blood tests indicate immune system cells penetrating the synovial membrane of joints and tendons, resulting in inflammation. This is similar to the autoimmune process in which the body tissues are attacked by its own immune system. Infection. The sudden start of PMR and the nature of the symptoms like joint pain, fever, and malaise, are suspected to be a result of infections caused by viruses. Environmental factors/exposure to sunlight. Damage of superficial arteries by over exposure to ultra violet radiation from the sun is another proposed cause for the development of PMR. Some studies suggest the elastic fibers present in the arteries and synovial membranes are damaged by ultra violet rays. These damaged tissues may get infected by viruses that remain dormant for a long time and may get reactivated later, causing PMR.

• #35

  https://step2.medbullets.com/rheumatology/120723/polymyalgia-rheumatica

  Epidemiology […] Demographics […] female male […] 50 years of age […] Risk factors […] winter months […] viral infections […] […] […] pathogenesis is unclear but may be triggered by environmental factors such as winter or viral infections and inflammatory cytokines play a key role […] […] […] ~50% of patients experience relapse

• #36

  https://reu.termedia.pl/Polymyalgia-rheumatica-and-cancer-the-surveillance-duration-and-other-points-to-ponder,156698,0,1.html

  The association of PMR with cancer has some points to ponder and clarify. A more rigorous and homogeneous methodological approach is crucial. A fast-track clinic for PMR patients suspected of cancer could be useful. Engagement and training of primary healthcare providers are highly recommended to accelerate PMR diagnosis and early detection of associated neoplastic sequelae.

• #37

  https://reu.termedia.pl/Polymyalgia-rheumatica-and-cancer-the-surveillance-duration-and-other-points-to-ponder,156698,0,2.html

  The association of PMR with cancer has some points to ponder and clarify. A more rigorous and homogeneous methodological approach is crucial. A fast-track clinic for PMR patients suspected of cancer could be useful. Engagement and training of primary healthcare providers are highly recommended to accelerate PMR diagnosis and early detection of associated neoplastic sequelae.

• #38

  https://reu.termedia.pl/Polymyalgia-rheumatica-and-cancer-the-surveillance-duration-and-other-points-to-ponder,156698,0,2.html

  Polymyalgia rheumatica (PMR) is one of the most common inflammatory rheumatic disease affecting the elderly. Up to 20% of patients with PMR may develop giant cell arteritis (GCA), a primary granulomatous vasculitis affecting the aorta and its branches. The association of PMR with GCA, also known as Hortons disease, has therapeutic and prognostic consequences. […] Polymyalgia rheumatica diagnosis is essentially clinical in the absence of a gold standard diagnostic text. Although studies from institutional databases typically include a large case series, diagnoses of the various diseases are based on coding and not always confirmed by individual medical record reviews. Therefore, registry-based studies may be at the risk of misdiagnosis/misclassification. On the other hand, cohort studies have much less data. Nonetheless, they can have higher diagnostic or classification accuracy, because these patients are carefully chosen to answer a specific research question.

• #39 Polymyalgia rheumatica: An updated review | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/9/549

  The PMR classification criteria proposed in 2012 by the European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR) include optional ultrasonographic criteria, allotting a point for either bilateral shoulder pathology or concomitant shoulder and hip findings. Use of ultrasonographic criteria increases the specificity of the EULAR/ACR classification system from 81.5% to 91.3%. […] Regardless of the medication regimen used, patients should be followed closely in the first year after starting treatment, at 0, 1 to 3, and 6 weeks, and at 3, 6, 9, and 12 months. Additional visits should be arranged as needed for new or worsening symptoms.

• #40 Polymyalgia rheumatica – an up-to-date review on diagnosis and management

  https://www.oaepublish.com/articles/2574-1209.2023.137

  The non-specific acute phase reactants, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP) are the most commonly used serum inflammation markers in PMR, and form part of the 2012 EULAR/ACR classification criteria for PMR. […] However, although both of these markers are typically elevated in PMR, there is a subpopulation of patients in whom these markers remain normal. […] Over the past decade, there have been significant advancements in imaging techniques in PMR, with subsequent improvements in our diagnostic ability. […] The most superior imaging modality for the diagnosis of PMR remains elusive; however, musculoskeletal US is the only modality to be incorporated into classification criteria, precisely the optional 2012 EULAR/ACR classification criteria. […] Glucocorticoids have served as the cornerstone of the management of PMR for decades.

• #41 Traditional and Emerging Strategies for Managing Polymyalgia Rheumatica: Insights into New Treatments

  https://www.mdpi.com/2077-0383/13/21/6492

  Polymyalgia Rheumatica (PMR) is an inflammatory condition that primarily affects individuals aged 50 and older, especially in Western countries. […] PMR primarily affects adults over 50, occurring more frequently in women than in men, and is more common among individuals of Northern European ancestry. Its incidence follows a north–south gradient, being higher in Scandinavian countries and lower in Southern European populations. […] Studies using imaging techniques like FDG-PET-CT and ultrasound have identified evidence of inflammation in large vessels, such as the aorta and its branches, in up to one-third of patients with isolated PMR. This suggests that some PMR patients might have underlying GCA, even in the absence of classic symptoms. […] Relapses occur in 20% to 60% of patients, mainly during the first year of treatment, and are characterized by the return of symptoms similar to those at diagnosis, typically presenting as pain and stiffness in the shoulders and arms.

• #42 Traditional and Emerging Strategies for Managing Polymyalgia Rheumatica: Insights into New Treatments

  https://www.mdpi.com/2077-0383/13/21/6492

  Current guidelines for managing PMR relapses are based primarily on an expert consensus and retrospective analyses. […] The primary goal in treating PMR is to control symptoms and prevent relapses, with oral prednisone/prednisolone being the main treatment. […] The 2015 EULAR/ACR guidelines recommend considering early methotrexate use for patients at high risk of relapses or those facing prolonged therapy, especially if they have comorbidities or are on other medications that increase the likelihood of glucocorticoid side effects. […] Biologic agents are employed in PMR patients who have refractory disease, experience relapses, or require a rapid discontinuation of glucocorticoids due to comorbidities that render their use undesirable. […] Several placebo-controlled trials support the beneficial effect of the anti-IL-6 receptor blockade for the management of PMR. […] The use of secukinumab, canakinumab, rituximab, and abatacept in PMR is an area of ongoing research, with varying degrees of evidence and clinical experience. […] The potential favorable effects of JAK inhibitors in isolated PMR remain to be determined.

• #43 Polymyalgia Rheumatica: New Tricks for an Old Disease – The Rheumatologist

  https://www.the-rheumatologist.org/article/polymyalgia-rheumatica-new-tricks-for-an-old-disease/

  Polymyalgia rheumatica (PMR) is a chronic inflammatory condition that almost exclusively affects individuals older than 50. […] Many patients with PMR receive high cumulative doses of glucocorticoids, with over half remaining on glucocorticoids two years after diagnosis and approximately 25% remaining on glucocorticoids after five years. […] The 2015 EULAR/ACR recommendations for the management of PMR suggest methotrexate as a glucocorticoid-sparing agent, but studies of its utility have been mixed. […] Based on the SAPHYR study, the FDA has now approved sarilumab for PMR; however, which patients should receive it will be an important question to answer in coming years. […] It seems clear that the next decade of research and therapeutics for PMR will be full of excitement and innovation.

• #44 Polymyalgia rheumatica – an up-to-date review on diagnosis and management

  https://www.oaepublish.com/articles/2574-1209.2023.137

  Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatic disease in those over the age of 50 years. The incidence increases progressively with age, with a peak incidence occurring in those between 70-79 years of age, suggesting that aging is central to its pathophysiology. There is a female preponderance, with more than two-thirds of those diagnosed with PMR being female. The lifetime incidence risk of PMR is estimated at 2.43% for females and 1.66% for males. […] PMR remains understudied. However, it appears that we are on the cusp of a new era in its diagnosis and management, with the evolution of imaging modalities and resultant improved understanding of disease pathogenesis, and subsequent identification of new therapeutic targets. The objective of this review is to summarise the recent advances in PMR, including its diagnosis and management, and identify future areas for research.

• #45 Polymyalgia rheumatica – an up-to-date review on diagnosis and management

  https://www.oaepublish.com/articles/2574-1209.2023.137

  Although we have an increased awareness of the prevalence of subclinical GCA in those with PMR, there are a number of unanswered questions surrounding it. […] Given the likelihood that greater than 1 in 5 patients with PMR may have subclinical vasculitis, the routine implementation of screening most certainly warrants consideration. […] Standard lower-dose glucocorticoid tapers employed in PMR treatment are usually sufficient to relieve PMR symptomatology. […] Controlled, blinded prospective studies exploring the stratification of patients with subclinical PMR are of utmost urgency and indeed importance, in order to best manage these patients and potentially prevent long-term vascular complications. […] The typical presenting symptom is sudden onset bilateral shoulder pain and stiffness, a feature which is present in up to 95% of those diagnosed with PMR.

• #46 Norwegian society of rheumatology recommendations on diagnosis and treatment of patients with Polymyalgia Rheumatica: a narrative review | BMC Rheumatology | Full Text

  https://bmcrheumatol.biomedcentral.com/articles/10.1186/s41927-024-00422-6

  The current recommendations were developed by the Norwegian PMR working group. […] The evidence on diagnostics and treatment of PMR published from January 1st, 2015, to March 31st, 2024, was reviewed and included in this work. […] PMR/GCA-fast track circuits may be important measures to secure prompt and accurate diagnostic work-up for these patients. […] Developed from a narrative review of available evidence and international consensus on PMR management, this guideline offers ten key recommendations for diagnosis and treatment.

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