The polymyalgia rheumatica activity score in daily use: Proposal for a definition of remission

Abstract

Abstract Objective To confirm the reliability and applicability of the Polymyalgia Rheumatica Disease Activity Score (PMR‐AS), and to establish a threshold for remission. Methods First, 78 patients with PMR (50 women/28 men, mean age 65.97 years) were enrolled in a cross‐sectional evaluation. The PMR‐AS, patient's satisfaction with disease status (PATSAT; range 1–5), erythrocyte sedimentation rate (ESR; first hour), and a visual analog scale of patients' general health assessment (VAS patient global; range 0–100) were recorded. Subsequently, another 39 PMR patients (24 women/15 men, mean age 68.12 years) were followed longitudinally. Relationships between the PMR‐AS, PATSAT, ESR, and VAS patient global were analyzed by the Kruskal‐Wallis test, Spearman's rank correlation, and kappa statistics. PMR‐AS values in patients with a PATSAT score of 1 and a VAS patient global <10 formed the basis to establish a remission threshold. Results PMR‐AS values were significantly related to PATSAT ( P < 0.001), VAS patient global ( P < 0.001), and ESR ( P < 0.01). PATSAT and VAS patient global were reasonably different (κ = 0.226). The median PMR‐AS score in patients with PATSAT score 1 and VAS patient global <10 was 0.7 (range 0–3.3), and the respective 75th percentile was 1.3. To enhance applicability, a range from 0 to 1.5 was proposed to define remission in PMR. The median ESR in these patients was 10 mm/hour (range 3–28), indicating external validity. Conclusion We demonstrated the reliability, validity, and applicability of the PMR‐AS in daily routine. Moreover, we proposed a remission threshold (0–1.5) founded on patient‐dependent parameters.