Table 4

Parameters considered as ‘important’ for defining remission of polymyalgia rheumatica by at least 80% of rheumatologists (RMs)

ParameterLimitsAgreement (%)
Morning stiffness*<15 min94.7
<30 min5.3
Erythrocyte sedimentation rate*<20 mm/1st h57.9
<30 mm/1st h31.6
<40 mm/1st h10.5
C-reactive protein* <0.5 mg/dl68.4
<0.8 mg/dl10.5
<1.0 mg/dl21.2
Patient's assessment of pain related to neck, upper arms, shoulders and pelvic girdle (VAS)<10 mm58.8
<20 mm35.3
<25 mm5.9
Corticosteroid dose required to control symptoms*Limit not specified
Shoulder-pain worsened by passive and active mobilisationQualitative item
Limitation of upper limb elevationQualitative item
Clinical signs of coxofemoral synovitis§Qualitative item
  • The corresponding proposals for limits of metric parameters and the agreement to these limits are given.

  • * Consensus on this parameter was already obtained in the first Delphi round.

  • Upper limit of a normal C-reactive protein value is 0.5 mg/dl.

  • A certain corticosteroid dose limit for remission on treatment medication (ie, when a patient is still on corticosteroids) was not specified by RMs in the Delphi survey. Corticosteroid dose of zero defines the case of remission off medication (ie, when the patient stopped taking corticosteroids).

  • § Coxofemoral synovitis is suggested if the patient complains about pain in the groin worsened by passive and active movements on clinical examination.

  • VAS, visual analogue scale with 0=no pain, 10=unbearable pain on a 10 cm scale.