Skip to main content

Research Repository

Advanced Search

Comorbidities in patients with polymyalgia rheumatica prior to and following diagnosis: A case control and cohort study

Partington, Richard; Muller, Sara; Mallen, Christian D; Abdul Sultan, Alyshah; Helliwell, Toby

Comorbidities in patients with polymyalgia rheumatica prior to and following diagnosis: A case control and cohort study Thumbnail


Authors

Alyshah Abdul Sultan



Abstract

Objectives: To determine the burden of comorbidities, including glucocorticoid (GC) related adverse effects, in patients with polymyalgia rheumatica (PMR) before and after diagnosis.

Methods: We extracted anonymised electronic medical records of patients over the age of 40 years from the Clinical Practice Research Datalink from 1990-2016. Patients with PMR were individually matched on age, sex and registered General Practice to between three and five controls. The prevalence, cumulative probability and likelihood of a range of comorbidities was estimated. Odds ratios (ORs) and hazard ratios (HRs) were calculated using conditional logistic regression and Cox proportional hazards regression respectively, adjusted for a wide range of covariates.

Results: 31,984 patients with PMR were matched to 149,436 controls. PMR was prospectively associated with vascular disease (adjusted HR 1.23 [95% confidence interval (CI) 1.19, 1.28]), as well as respiratory (HR 1.25 [1.18, 1.32]), renal (HR 1.34 [1.30, 1.39]), and autoimmune diseases (HR 4.68 [4.35, 5.03]). Conversely, before PMR diagnosis, the risk of cancer (adjusted OR [OR] 0.89 [0.86, 0.93]) and neurological disease (OR 0.36 [0.33, 0.40]) was significantly lower. Patients with PMR had an increased risk of comorbidities associated with glucocorticoid (GC) use.

Conclusions
Patients with PMR have a high comorbidity burden, both before and after diagnosis. Whilst further work is needed to more fully understand these associations, clinicians should be aware of the high prevalence of comorbid conditions in this group and the impact that treatment with glucocorticoids may have on comorbidity.

Citation

Partington, R., Muller, S., Mallen, C. D., Abdul Sultan, A., & Helliwell, T. (2020). Comorbidities in patients with polymyalgia rheumatica prior to and following diagnosis: A case control and cohort study. Seminars in Arthritis and Rheumatism, 50(4), 663-672. https://doi.org/10.1016/j.semarthrit.2020.05.003

Journal Article Type Article
Acceptance Date May 15, 2020
Online Publication Date May 26, 2020
Publication Date 2020-08
Journal Seminars in Arthritis and Rheumatism
Print ISSN 0049-0172
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 50
Issue 4
Pages 663-672
DOI https://doi.org/10.1016/j.semarthrit.2020.05.003
Keywords Polymyalgia rheumatica; Epidemiology; Comorbidity; Cohort; Case control
Publisher URL https://doi.org/10.1016/j.semarthrit.2020.05.003
PMID 32512261

Files






You might also like



Downloadable Citations