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Review
. 2022 Jun 17;119(24):411-417.
doi: 10.3238/arztebl.m2022.0218.

Polymyalgia Rheumatica

Miriam Giovanna Colombo  1 , Anna-Jasmin Wetzel, Hannah Haumann, Simon Dally, Gudula Kirtschig, Stefanie Joos
Affiliations
Review

Polymyalgia Rheumatica

Miriam Giovanna Colombo et al. Dtsch Arztebl Int. .

Abstract

Background: 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.

Methods: This review is based on publications retrieved by a selective literature search in PubMed. Moreover, the administrative incidence and prevalence of PMR in the years 2011-2019 was determined from data of the AOK Baden-Württemberg statutory health insurance carrier for insurees aged 40 and older. In addition, we quantified the number of consultations with physicians involved in the diagnosis.

Results: 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). 60% of the cases were diagnosed in primary care practices. The treatment of PMR with orally administered glucocorticoids usually results in a treatment response within a few days to weeks. Approximately 43% of patients experience recurrent symptoms within a year, requiring adjustment of the glucocorticoid dose. For older patients with impaired physical ability, additional non-pharmacological treatment with exercise programs plays an important role.

Conclusion: PMR usually takes an uncomplicated course under treatment and can be managed in primary care, but these patients are often multimorbid and require frequent follow-up. Along with research on the etiology of the disease, further studies are needed to identify the risk factors for a chronic course and to evaluate the potential effects of non-pharmacological measures.

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Figures

FIGURE 1
FIGURE 1
Age-standardized incidence (top) and prevalence (bottom) of polymyalgia rheumatica (PMR) in men and women ≥ 40 years in the period 2011–2019. The exact values for the crude and standardized incidence and prevalence rates are shown in the eTable. The standard populations for calculating the age-standardized incidence rates were respectively all women and all men insured through the statutory health insurance (SHI) system for the year 2019 (7).
Figure 2
Figure 2
Number (upper) and percentage (lower) of consultations with medical specialists by persons insured with the AOK Baden–Württemberg aged ≥ 40 years with new-onset polymyalgia rheumatica (PMR) in the incident and subsequent quarter, 2011–2019.
eFigure
eFigure
Number (upper) and percentage (lower) of consultations with medical specialists by persons insured with the AOK Baden–Württemberg aged ≥ 40 years with new-onset PMR in the incident and subsequent quarter, stratified by sex, 2011–2019. PMR, polymyalgia rheumatica
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Comment in

References

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