P148 Gastrointestinal symptoms and proton pump inhibitor use in patients with polymyalgia rheumatica: results from the PMR Cohort study

Feddah, Hamzeh; Muller, Sara; Hider, Samantha; Hay, Charles; Mallen, Christian

Abstract

Background
Polymyalgia Rheumatica (PMR) is a common disorder of older adults, characterised by pain and stiffness in the shoulders and hips. PMR is one of the commonest indications for long-term glucocorticoid use. Because of the well-recognised side effects of glucocorticoids including gastrointestinal disturbances and bleeding, guidelines recommend consideration of gastrointestinal prophylaxis. The aim of this study was to assess the proportion of PMR patients who report 1) gastrointestinal disturbances; and 2) appropriate prophylactic treatment, and to investigate other factors that may be associated with the development of gastrointestinal disturbances.

Methods
652 people diagnosed in primary care with incident PMR were recruited. Participants all responded to a baseline postal survey and were followed up postally at 1, 4, 8, 12, 18 and 24 months. At each time point, participants answered a range of questions relating sociodemographic, general health and their PMR. At baseline, respondents reported proton pump inhibitors (PPI) use and at 4, 12 and 24 months the presence and extent of any gastrointestinal symptoms (ulcer, wind, indigestion, heartburn; not bothered, bothered a little, bothered a lot). The association of gastrointestinal symptoms with age, gender and PPI use was quantified using proportional odds regression.

Results
Overall, 51% of people reported PPI use at baseline. Reporting of gastrointestinal symptoms was commoner at all time points in people prescribed a PPI at baseline (Table 1). There was no association between age and bothersomeness of gastrointestinal symptoms (odds ratio 0.98 (0.96, 1.00)), but more bothersome symptoms were more likely in females (2.44 (1.72, 3.45)). PPI use at baseline was significantly associated with a high level of bothersomeness compared to no/little bother (2.45 (13.39, 4.36)), but not with being bothered compared to not being bothered (1.23 (0.87, 1.74)).

Citation

Feddah, H., Muller, S., Hider, S., Hay, C., & Mallen, C. (2020, April). P148 Gastrointestinal symptoms and proton pump inhibitor use in patients with polymyalgia rheumatica: results from the PMR Cohort study. Poster presented at British Society for Rheumatology Annual Conference 2020, - Cancelled -

• Presentation Conference Type: Poster
• Conference Name: British Society for Rheumatology Annual Conference 2020
• Conference Location: - Cancelled -
• Start Date: Apr 20, 2020
• End Date: Apr 22, 2020
• Deposit Date: Jun 23, 2023
• Publisher: Oxford University Press
• DOI: https://doi.org/10.1093/rheumatology/keaa111.143
• Keywords: Pharmacology (medical); Rheumatology; hemorrhage; ulcer; glucocorticoids; disclosure; dyspepsia; heartburn; hip region; pain; polymyalgia rheumatica; primary health care; signs and symptoms, digestive; guidelines; gender; shoulder region; wind; proton pump inhibitors; older adult; prescribing behavior; adverse effects in therapeutic use of glucocorticoids and synthetic analogs; prevention