Definitions for relapse of polymyalgia rheumatica from the published literature
| Reference | Elevation of ESR* (mm/1st h) | Elevation of CRP (mg/dl) | Flare of PMR clinical features* | Response to corticosteroids* |
|---|---|---|---|---|
| Amoli et al51 | – | – | Yes | Yes |
| Ayoub et al38 | – | – | Yes | Yes |
| Bahlas et al33 | – | – | Yes | Yes |
| Bengtsson and Malmvall28 | – | – | Yes | – |
| Behn et al30 | NN | – | Yes | – |
| Blockmans et al21 | >40 (NN) | >3.0 (NN)† | MS, proximal girdle pain | – |
| Cantini et al27 | >30 (NN) | – | Yes | Yes |
| Caporali et al10 | >30‡ | >0.5 | Aching and stiffness at shoulder, hip girdle, or both | – |
| Catanoso et al9 | ≥40‡ | ≥0.5† | Typical proximal musculoskeletal symptoms, MS ≥1 h | – |
| Ceccato et al52 | NN | – | Yes | Yes |
| Chuang et al41 | NN | – | Yes | Yes |
| Cimmino et al53 54 | >30‡ | >0.5 | Aching and stiffness at shoulder and/or hip girdle | – |
| Cutolo et al55 | >30 (NN) | – | Yes | – |
| Delecoeuillerie et al43 | – | – | Yes | Yes |
| Ferraccioli et al45 | >100% more than previous assessment‡ | >100% more than previous assessment | Return of myalgia | – |
| González-Gay et al32 | NN | – | Yes | Yes |
| González-Gay et al56 | – | – | Yes | Yes |
| Hachulla et al22 | >30‡ | >1.2¶ | Fever, proximal aching and MS, myalgia, weakness, weight loss, headache (NN)§ | Yes (or to dapsone) |
| Hutchings et al46 | – | – | Yes | Yes or maintenance of the steroid dose beyond a scheduled reduction |
| Kremers et al31 | – | – | Yes | Yes (and requiring a dose increment ≥5 mg/day) |
| Kremers et al34 | – | – | Yes | Yes |
| Kyle and Hazleman57 | – | – | Pain and stiffness in the shoulder or hip girdle | – |
| Lundberg and Hedfors58 | – | – | Yes | Yes |
| Mertens et al49 | – | – | Yes | Yes |
| Narváez et al23 | Yes | – | Yes | Yes |
| Pego-Reigosa et al24 | – | – | Yes | – |
| Proven et al36 | Yes | – | Yes | – |
| Pulsatelli et al59 | >30 | >0.5† | Yes | Yes |
| Salvarani et al25 60 | >30 (NN) | – | Yes | – |
| Salvarani et al26 | >30‡ | >0.5† | Yes | Yes |
| Salvarani et al8 | >30‡ | >0.5† | Aching and stiffness at shoulder, hip girdle or both | Yes |
| van der Veen et al50 | >100% more than previous assessment‡ | >100% more than previous assessment | Yes | – |
| von Knorring29 | NN | – | Yes | Yes |
–, parameter not mentioned in the definition.
↵* Not further specified unless otherwise stated.
↵‡ Incremental change in either ESR or CRP for the definition of relapse.
↵§ No other intercurrent inflammatory syndrome.
CRP, C-reactive protein; the upper limit of normal is
↵† 0.5 mg/dl and ¶1.2 mg/dl (for the other studies, no upper limit of normal CRP levels was reported); ESR, erythrocyte sedimentation rate; MS, morning stiffness; NN, not necessarily.