title: Patient-reported outcomes in polymyalgia rheumatica.
abstract: OBJECTIVE
  To prospectively evaluate the disease course and the performance of clinical, patient-reported outcome (PRO) and musculoskeletal ultrasound measures in patients with polymyalgia rheumatica (PMR).
  
  
  METHODS
  The study population included 85 patients with new-onset PMR who were initially treated with prednisone equivalent dose of 15 mg daily tapered gradually, and followed for 26 weeks. Data collection included physical examination findings, laboratory measures of acute-phase reactants, and PRO measures. Ultrasound evaluation was performed at baseline and Week 26 to assess for features previously reported to be associated with PMR. Response to corticosteroid treatment was defined as 70% improvement in PMR on visual analog scale (VAS).
  
  
  RESULTS
  At baseline, 77% had hip pain in addition to shoulder pain and 100% had abnormal C-reactive protein or erythrocyte sedimentation rate. On ultrasound, 84% had shoulder findings and 32% had both shoulder and hip findings. Response to corticosteroid treatment occurred in 73% of patients by Week 4 and was highly correlated with percentage improvement in other VAS measures. Presence of ultrasound findings at baseline predicted response to corticosteroids at 4 weeks. Factor analysis revealed 6 domains that sufficiently represented all the outcome measures: PMR-related pain and physical function, an elevated inflammatory marker, hip pain, global pain, mental function, and morning stiffness.
  
  
  CONCLUSIONS
  PRO measures and inflammatory markers performed well in assessing disease activity in patients with PMR. A minimum set of outcome measures consisting of PRO measures of pain and function and an inflammatory marker should be used in practice and in clinical trials in PMR.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. matteson.eric@mayo.edu
authors.forename: Eric L
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authors.lastname: Matteson
authors.forename: Hilal
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authors.lastname: Maradit-Kremers
authors.forename: Marco A
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authors.lastname: Cimmino
authors.forename: Wolfgang A
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authors.lastname: Schmidt
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authors.forename: Gyula
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authors.forename: Zsuzsa
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authors.lastname: Schmidt
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authors.lastname: Iagnocco
authors.forename: Fabrizio
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authors.lastname: Cantini
authors.forename: Carlotta
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authors.lastname: Macchioni
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authors.lastname: Pipitone
authors.forename: Montserrat
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authors.lastname: Del Amo
authors.forename: Georgina
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authors.lastname: Espígol-Frigolé
authors.forename: Maria C
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authors.lastname: Cid
authors.forename: Víctor M
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authors.lastname: Martínez-Taboada
authors.forename: Elisabeth
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authors.lastname: Nordborg
authors.forename: Haner
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authors.lastname: Direskeneli
authors.forename: Sibel Zehra
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authors.lastname: Aydin
authors.forename: Khalid
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authors.lastname: Ahmed
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authors.lastname: Hazelman
authors.forename: Colin
authors.initials: C
authors.lastname: Pease
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wakefield
authors.forename: Raashid
authors.initials: R
authors.lastname: Luqmani
authors.forename: Andy
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authors.lastname: Abril
authors.forename: Ralph
authors.initials: R
authors.lastname: Marcus
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Gonter
authors.forename: Mehrdad
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authors.lastname: Maz
authors.forename: Cynthia S
authors.initials: CS
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mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D016903:Drug Monitoring / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011111:Polymyalgia Rheumatica / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000503:physiopathology; D011241:Prednisone / Q000008:administration & dosage*; D011446:Prospective Studies; D014463:Ultrasonography
chemical_list: D000893:Anti-Inflammatory Agents; D011241:Prednisone