Table 3

Definitions for relapse of polymyalgia rheumatica from the published literature

ReferenceElevation of ESR* (mm/1st h)Elevation of CRP (mg/dl)Flare of PMR clinical features*Response to corticosteroids*
Amoli et al51YesYes
Ayoub et al38YesYes
Bahlas et al33YesYes
Bengtsson and Malmvall28Yes
Behn et al30NNYes
Blockmans et al21>40 (NN)>3.0 (NN)MS, proximal girdle pain
Cantini et al27>30 (NN)YesYes
Caporali et al10>30>0.5Aching and stiffness at shoulder, hip girdle, or both
Catanoso et al9≥40≥0.5Typical proximal musculoskeletal symptoms, MS ≥1 h
Ceccato et al52NNYesYes
Chuang et al41NNYesYes
Cimmino et al53 54>30>0.5Aching and stiffness at shoulder and/or hip girdle
Cutolo et al55>30 (NN)Yes
Delecoeuillerie et al43YesYes
Ferraccioli et al45>100% more than previous assessment>100% more than previous assessmentReturn of myalgia
González-Gay et al32NNYesYes
González-Gay et al56YesYes
Hachulla et al22>30>1.2¶Fever, proximal aching and MS, myalgia, weakness, weight loss, headache (NN)§Yes (or to dapsone)
Hutchings et al46YesYes or maintenance of the steroid dose beyond a scheduled reduction
Kremers et al31YesYes (and requiring a dose increment ≥5 mg/day)
Kremers et al34YesYes
Kyle and Hazleman57Pain and stiffness in the shoulder or hip girdle
Lundberg and Hedfors58YesYes
Mertens et al49YesYes
Narváez et al23YesYesYes
Pego-Reigosa et al24Yes
Proven et al36YesYes
Pulsatelli et al59>30>0.5YesYes
Salvarani et al25 60>30 (NN)Yes
Salvarani et al26>30>0.5YesYes
Salvarani et al8>30>0.5Aching and stiffness at shoulder, hip girdle or bothYes
van der Veen et al50>100% more than previous assessment>100% more than previous assessmentYes
von Knorring29NNYesYes
  • –, 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.