Predictors of long-term therapy with glucocorticoid in polymyalgia rheumatica

Abstract

Objectives To investigate the response of glucocorticoid (GC) therapy for patients with polymyalgia rheumatica (PMR) and predictive factors which correspond to the long-term GC. Methods We reviewed 93 patients with PMR who were treated with GC for more than 6 months. We compared the clinical findings between patients who achieved remission within 24 months (early-remission group, n = 40) and those who required GC therapy for more than 24 months (long-therapy group, n = 24). Results Among 93 patients, 49 have achieved a remission, 35 were undergoing treatment, and 9 have transferred to other hospitals or died. Rate of remission of patients treated for one year GC therapy was in 12% and 53% after 2 years. Serum CRP of long-therapy group was significantly higher than those of the early-remission group. The ratio of patients who experienced more than one relapse within 6 months was 37.5% of long-therapy group and 7.5% of early-remission group. Multivariate logistic regression analysis showed that the history of relapse until 6 months was a significant predictor of long therapy. Conclusions Some patients need the long-term therapy for more than 4 years. The history of relapse till 6 months is a significant predictor of the long-term GC therapy.