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The Current Standardized Classification Systems and Risk Factors in Polymyalgia Rheumatica

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Polymyalgia Rheumatica and Giant Cell Arteritis

Abstract

Polymyalgia rheumatica (PMR) is a clinical syndrome characterized by pain and stiffness in the neck, shoulder and pelvic girdles; this disorder is the most common inflammatory rheumatism in the elderly (Caucasian) population. Difficulties in differential diagnosis and therapeutic protocols in PMR, but also progress of technology (ultrasonography in particular), led in the past decade to the development of more precise guidelines (BSR/BHPR 2010), original classification criteria (EULAR/ACR 2012) and recommendations for management of PMR (EULAR/ACR 2015), which all reflect the state of the art in the field of PMR management and are the main focus of the present article. At the same time, the body of knowledge expanded as concerns the major risk factors in PMR, primarily those related to overlap with giant cell arteritis, probability of malignant tumours and responsiveness to and/or toxicity of long-term (glucocorticoid) therapy. The current standardized classification systems contribute to reduction of risk factors associated with PMR. Adherence to these systems is an important precondition for a good clinical practice, especially in rheumatology.

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References

  1. Rooney PJ, Rooney J, Balint G, Balint P. Polymyalgia rheumatica: 12 years of epidemiological progress? Scott Med J. 2015;60:50–7.

    Article  PubMed  Google Scholar 

  2. Bruce W. Senile rheumatic gout. Br Med J. 1888;2:811–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Barber HS. Myalgic syndrome with constitutional effects: polymyalgia rheumatica. Ann Rheum Dis. 1957;16:230–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Bird HA, Esselinckx W, Dixon ASJ, Mawat AG, Wood PHN. An evaluation of criteria for polymyalgia rheumatica. Ann Rheum Dis. 1979;38:434–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Jones JG, Hazleman BL. Prognosis and management of polymyalgia rheumatica. Ann Rheum Dis. 1981;40:1–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Chuang TY, Hunder GG, Ilstrup DM, Kurland LT. Polymyalgia rheumatica: a 10-year epidemiologic and clinical study. Ann Intern Med. 1982;97:672–80.

    Article  CAS  PubMed  Google Scholar 

  7. Nabunaga M, Yashioka K, Yasuada M, Shingu M. Clinical studies of polymyalgia rheumatica: a proposal diagnostic criteria. Jpn J Med. 1989;28:452–6.

    Article  Google Scholar 

  8. Bird HA, Leeb BF, Montecucco CM, Misiuniene N, Nesher G, Pai S, et al. A comparison of the sensitivity of diagnostic criteria for polymyalgia rheumatica. Ann Rheum Dis. 2005;64:626–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Dasgupta B, Borg FA, Hassan N, Barraclough K, Bourke B, Fulcher J, et al. BSR and BHPR guidelines for the management of polymyalgia rheumatica. Rheumatology. 2010;49:186–90.

    Article  PubMed  Google Scholar 

  10. Dasgupta B, Cimmino MA, Kremers HM, Schmidt WA, Schirmer M, Salvarani C, et al. 2012 provisional classification criteria for polymyalgia rheumatica. Arthritis Rheum. 2012;64:943–54.

    Article  PubMed  Google Scholar 

  11. Dejaco C, Singh YP, Perel P, Hutchings A, Camellino D, Mackie S, et al. 2015 recommendations for the management of polymyalgia rheumatica. Arthritis Rheum. 2015;67:2569–80.

    Article  Google Scholar 

  12. Aggarwal R, Ringold S, Khanna D, Neogi T, Johnson SR, Miller A, et al. Distinctions between diagnostic and classification criteria? Arthritis Care Res. 2015;67:891–7.

    Article  Google Scholar 

  13. Hrncir Z, Brtková J. Recent normative systems and risk factors in polymyalgia rheumatica. Čes Revmatol. 2016;24:38–46. (in Czech).

    Google Scholar 

  14. Weigand S, Ehrenstein B, Fleck M, Hartung W. Joint involvement in patients with early polymyalgia rheumatica using high-resolution ultrasound and its contribution to the EULAR/ACR 2012 classification criteria for polymyalgia rheumatica. J Rheumatol. 2014;41:730–4.

    Article  PubMed  Google Scholar 

  15. Macchioni P, Boiardi L, Catanoso M, Pazzola G, Salvarani C. Performance of the new 2012 EULAR/ACR classification criteria for polymyalgia rheumatica: comparison with the previous criteria in a single-centre study. Ann Rheum Dis. 2014;73:1190–3.

    Article  PubMed  Google Scholar 

  16. Lopez-Hoyos M, Ruiz de Alegria C, Blanco R, Crespo J, Peňa M, Rodrigez-Valverde V, et al. Clinical utility of anti-CCP antibodies in the differential diagnosis of elderly-onset rheumatoid arthritis and polymyalgia rheumatica. Rheumatology. 2004;43:655–7.

    Article  CAS  PubMed  Google Scholar 

  17. Caylor TL, Perkins A. Recognition and management of polymyalgia rheumatica and giant cell arteritis. Am Fam Physician. 2013;88:676–84.

    PubMed  Google Scholar 

  18. Smetana GW, Shmerling RH. Does this patient have temporal arteritis? JAMA. 2002;287:92–101.

    Article  PubMed  Google Scholar 

  19. Warrington KJ, Weyand CM. Giant cell arteritis and polymyalgia rheumatica. In: Ball GV, Fessler FJ, Bridges Jr SL, editors. Oxford textbook of vasculitis. 3rd ed. Oxford: Oxford University Press; 2014. p. 307–18.

    Chapter  Google Scholar 

  20. Gonzales-Gay MA, Carcia-Porrua C, Amor-Dorado JC, Llorca J. Fever in biopsy-proven giant cell arteritis: clinical implication in a defined population. Arthritis Care Res. 2004;51:652–5.

    Article  Google Scholar 

  21. Rencová E, Hrncir Z, Rozsíval P. Oční projevy u revmatických chorob. In: Rozsíval P, editor. Trendy soudobé oftalmologie. 1st ed. Praha: Galén; 2006. p. 135–82.

    Google Scholar 

  22. Muller S, Hider SL, Belcher J, Helliwell T, Mallen CD. Is cancer associated with polymyalgia rheumatica? A cohort study in the general practice research database. Ann Rheum Dis. 2014;73:1769–73.

    Article  PubMed  Google Scholar 

  23. Jinguang J, Xiangdong L, Sundquist K, Sundquist J, Hemminki K. Cancer risk in patients hospitalized with polymyalgia rheumatica and giant cell arteritis: a follow-up study in Sweden. Rheumatology. 2010;49:1158–63.

    Article  Google Scholar 

  24. Witlock M, Hollywood J. Treatment guidelines for polymyalgia rheumatica: the nursing perspective. Rheumatology. 2014;53(Suppl 2):10.

    Article  Google Scholar 

  25. Hellmann DB. Giant cell arteritis, polymyalgia rheumatica, and Takayasu’s arteritis. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O’Dell JR, editors. Kelley’s textbook of rheumatology. 9th ed. Philadelphia: Elsevier; 2013. p. 1461–80.

    Chapter  Google Scholar 

  26. Aikawa NE, Pereira RMR, Lage L, Bonfá E, Carvalho JF. Anti-THF therapy for polymyalgia rheumatica: report of 99 cases and review of the literature. Clin Rheumatol. 2012;31:575–9.

    Article  PubMed  Google Scholar 

  27. Rashidi A, Hegazi MO, Mohammad SA, Varghese A. Effective control of polymyalgia rheumatica with tocilizumab. J Clin Rheumatol. 2013;19:400–1.

    Article  PubMed  Google Scholar 

  28. Unizony S, Arias-Urdaneta L, Miroslavsky E, Arvikar E, Khosroshahi A, Keroak B, et al. Tocilizumab for the treatment of large-vessel vasculitis (Giant cell arteritis, Takayasu arteritis) and polymyalgia rheumatica. Arthritis Care Res. 2012;64:1720–9.

    Article  CAS  Google Scholar 

  29. Leeb BF, Bird HA. A disease activity score for polymyalgia rheumatica. Ann Rheum Dis. 2004;63:1279–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Dejaco C, Duftner C, Cimmino MA, Dasgupta B, Salvarani C, Crowson CS, et al. Definition of remission and relapse in polymyalgia rheumatica: data from a literature search compared with a Delphi-based expert consensus. Ann Rheum Dis. 2011;70:447–53.

    Article  PubMed  Google Scholar 

  31. Salvarini C, Cantini F, Niccoli L, Machioni P, Consonni D, Bajocchi G, et al. Acute-phase reactants and the risk of relapse/recurrence in polymyalgia rheumatica: a prospective follow up study. Arthritis Care Res. 2005;53:33–8.

    Article  Google Scholar 

  32. van der Goes MC, Jacobs JWG, Jurgens MS, Bakker MF, van der Veen MJ, van der Werf JH, et al. Are changes in bone mineral density different between groups of early rheumatoid arthritis patients treated according to a tight control strategy with or without prednisone of osteoporosis prophylaxis in applied? Osteoporos Int. 2013;24:1429–36.

    Article  CAS  PubMed  Google Scholar 

  33. Grossman JM, Gordon R, Ranganath VK, Deal C, Caplan L, Chen W, et al. American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res. 2010;62:1515–26.

    Article  Google Scholar 

  34. Ramiro S, Gaujoux-Viala C, Nam JL, Smolen JS, Buch M, Gossec L, et al. Safety of synthetic and biological DMARDs: a systematic literature review informing the 2013 update of the EULAR recommendations for management of rheumatoid arthritis. Ann Rheum Dis. 2014;73:529–35.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgement

Supported by the Charles University Medical Faculty in Hradec Kralove research project PROGRESS 3715.

Author information

Authors and Affiliations

  1. II Department of Internal Medicine and Gastroenterology, Charles University, Prague, Czech Republic

    Zbyněk Hrnčíř

  2. University Hospital in Hradec Králové, Sokolská, Czech Republic

    Zbyněk Hrnčíř & Jindra Brtková

  3. Department of Radiology, Faculty of Medicine, Charles University, Prague, Czech Republic

    Jindra Brtková

Authors
  1. Zbyněk Hrnčíř
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  2. Jindra Brtková
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Corresponding author

Correspondence to Zbyněk Hrnčíř .

Editor information

Editors and Affiliations

  1. Department of Rheumatology, National Institute of Rheumatic Diseases, Piešťany, Slovakia

    Jozef Rovenský

  2. 2nd Department of Medicine, State Hospital of Stockerau, Stockerau, Austria

    Burkhard Leeb

  3. 2nd Internal Clinic Medical Faculty, Comenius University, Bratislava, Slovakia

    Viera Štvrtinová

  4. Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia

    Richard Imrich

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Hrnčíř, Z., Brtková, J. (2017). The Current Standardized Classification Systems and Risk Factors in Polymyalgia Rheumatica. In: Rovenský, J., Leeb, B., Štvrtinová, V., Imrich, R. (eds) Polymyalgia Rheumatica and Giant Cell Arteritis. Springer, Cham. https://doi.org/10.1007/978-3-319-52222-7_18

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  • DOI: https://doi.org/10.1007/978-3-319-52222-7_18

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52221-0

  • Online ISBN: 978-3-319-52222-7

  • eBook Packages: MedicineMedicine (R0)

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