E042 Predicting duration of glucocorticoid therapy in an inception cohort of patients with polymyalgia rheumatica

Morton, Chris; Muller, Sara; Hider, Samantha; Belcher, John; Mallen, Christian D; Helliwell, Toby

Abstract

Background: Extended duration of glucocorticoid (GC) therapy can be considered a poor outcome in people with polymyalgia rheumatica (PMR). Being able to predict the likelihood of extended GC therapy at diagnosis would enable earlier specialist referral for steroid-sparing treatments, with the aim of improving long-term outcomes.

Methods: An inception cohort of people with PMR was recruited from UK general practice. Individuals (n = 739) with a first read-coded consultation for PMR in primary care were mailed a baseline questionnaire, with repeated follow-up over the next two years. The questionnaires included items on a range of patient-reported symptoms and general health concepts, as well as current GC use (yes/no). Exact time of GC discontinuation was censored into the interval between consecutive questionnaires. The association between baseline predictors and duration of GC therapy was investigated using proportional hazards survival analysis, adjusted for all predictors displayed in Table 1. Multiple imputation was used to account for missing predictor data.

Results: 652 participants completed the baseline questionnaire. The mean age of participants was 72.4 years and 405 (62.1%) were female. After one and two years, 81% and 58% respectively were still using GCs. During follow-up 40 people (6.1%) resumed GC use after initially discontinuing: their initial discontinuation was used as the event time in the main analysis. In multivariable analysis (Table 1) male gender and self-reported ability to raise both arms above the head were associated with a shorter course of GC therapy. Lower levels of fatigue were associated with a longer treatment course.

Citation

Morton, C., Muller, S., Hider, S., Belcher, J., Mallen, C. D., & Helliwell, T. (2019). E042 Predicting duration of glucocorticoid therapy in an inception cohort of patients with polymyalgia rheumatica. Rheumatology, 58(Supplement_3), https://doi.org/10.1093/rheumatology/kez110.041

• Journal Article Type: Article
• Conference Name: British Society for Rheumatology Annual Conference 2019 Abstracts
• Online Publication Date: Apr 12, 2019
• Publication Date: Apr 1, 2019
• Deposit Date: Jun 26, 2023
• Journal: Rheumatology
• Print ISSN: 1462-0324
• Electronic ISSN: 1462-0332
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 58
• Issue: Supplement_3
• DOI: https://doi.org/10.1093/rheumatology/kez110.041
• Keywords: Pharmacology (medical); Rheumatology