Induction of Remission is Difficult due to Frequent Relapse during Tapering Steroids in Korean Patients with Polymyalgia Rheumatica
- Hyoun-Ah Kim; Jisoo Lee; You-Jung Ha; Sang-Hyon Kim; Chan-Hee Lee; Hyo-Jin Choi; Han-Joo Baek; Mie Jin Lim; Won Park; Sungiae Choi; Yeon-Sik Hong; Yoo-Hyun Lee; Bo-Ram Koh; Chang-Hee Suh
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- Polymyalgia Rheumatica; Symptoms; Treatment; Steroids; Remission; Prognosis
- Polymyalgia rheumatica is an inflammatory disease affecting elderly and involving the
shoulder and pelvic girdles. No epidemiological study of polymyalgia rheumatica was
conducted in Korea. We retrospectively evaluated patients with polymyalgia rheumatica
followed up at the rheumatology clinics of 10 tertiary hospitals. In total 51 patients, 36
patients (70.6%) were female. Age at disease onset was 67.4 yr. Twenty-three patients
(45.1%) developed polymyalgia rheumatica in winter. Shoulder girdle ache was observed
in 45 patients (90%) and elevated erythrocyte sedimentation rate (> 40 mm/h) in 49
patients (96.1%). Initial steroid dose was 23.3 mg/d prednisolone equivalent. Time to
normal erythrocyte sedimentation rate was 4.1 months. Only 8 patients (15.7%) achieved
remission. Among 41 patients followed up, 28 patients (68.3%) had flare at least once.
Number of flares was 1.5 ± 1.6. The frequency of flare was significantly lower in patients
with remission (P = 0.02). In Korea, polymyalgia rheumatica commonly develops during
winter. Initial response to steroid is fairly good, but the prognosis is not benign because
remission is rare with frequent relapse requiring long-term steroid treatment.
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