The polymyalgia rheumatica activity score in daily use: proposal for a definition of remission.
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 (kappa = 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.


CONCLUSIONS
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.
Leeb
Burkhard F
BF
Lower Austrian Center for Rheumatology, State Hospital Stockerau, Stockerau, Austria. leeb.humanis@kav-kost.at
Rintelen
Bernhard
B
Sautner
Judith
J
Fassl
Christian
C
Bird
Howard A
HA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001799:Blood Sedimentation; D003430:Cross-Sectional Studies; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011111:Polymyalgia Rheumatica / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D012074:Remission Induction; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D016896:Treatment Outcome
D005938:Glucocorticoids