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AB0451 Polymyalgia rheumatica is more severe in female patients: a prospective study.
  1. F. Muratore1,
  2. P. Macchioni1,
  3. L. Boiardi1,
  4. C. Salvarani1
  1. 1Rheumatology Unit, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy, Reggio Emilia, Italy

Abstract

Background Recent data showed a longer-course of corticosteroid (CS) therapy, higher cumulative CS dosage and increased number of relapses in female patients with polymyalgia rheumatica (PMR) than in male (1,2).

Objectives To assess gender-related differences in PMR activity and disease course using clinical, PMR-DAS (3), quality of life (QoL) and ultrasonographic (US) evaluation.

Methods All patients with suspected PMR seen at our centre are followed according to a standardized protocol that include clinical examination, determination of laboratory parameters (including ESR, CRP, RF, ACPA test), HAQ questionnaire and US examination of shoulders and hips. All patients are treated with a fixed prednisone start dosage (12.5 mg/day) for four weeks and then tapered according to a standardized protocol. Consecutive patients seen in our rheumatological centre with new onset PMR and followed for at least 6 months were included prospectively during a 5 years period.

Results The study cohort included 85 patients (24 m/61 f). At baseline visit there were no significant differences between male and female in demographic, clinical and laboratory data: age (76.2 ± 6.7 vs 74.6 ± 6.9 years, p ns); disease duration at diagnosis (12.8 ± 19.7 vs 15.3 ± 28.8 weeks, p ns); ERS (55.4 ± 18.9 vs 56.6 ± 24.2 mm/1sth, p ns); CRP (4.55 ± 2.3 vs 4.1 ± 3.5 mg/dl, p ns); PMR-DAS (36.9 ± 13.3 vs 36.8 ± 15.4 p ns); HAQ (1.7 ± 0.5 vs 1.8 vs 0.5 p ns); systemic symptoms (33.3% vs 45.9% p ns). At diagnosis a greater proportion of female patients showed at least one inflamed structure at US shoulder examination compared to male (100% vs 87%, p=0.004). Table 1 shows the significant differences between male an female at 6 months evaluation. At the end of the follow-up period 21 (87.5%) male and 55 (90.2%) female patients were still on steroid treatment (p ns) at a mean dose of 5.1 ± 5.3 and 5.2 ± 3.7 mg/day (p ns) respectively.

Conclusions At six month evaluation female patients had a more active disease compared to male. Number of relapses/recurrences are higher (but the difference was not significant) among female. At diagnosis only US shoulder examination showed a more severe disease in female compared to male patients.

  1. Narvaez J, Nolla-Solé JM, Valverde-García J, Roig-Escofet D Sex differences in temporal arteritis and polymyalgia rheumatica. J Rheumatol. 2002 Feb;29(2):321-5

  2. Cimmino MA, Parodi M, Caporali R, Montecucco C Is the course of steroid-treated polymyalgia rheumatica more severe in women? Ann N Y Acad Sci. 2006 Jun;1069:315-21

  3. Leeb BF, Bird HA A disease activity score for polymyalgia rheumatica. Ann Rheum Dis. 2004 Oct;63(10):1279-83

Disclosure of Interest None Declared

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