MORTALITY IN POLYMYALGIA RHEUMATICA: A 35-YEAR PROSPECTIVE OBSERVATIONAL STUDY FROM SOUTHERN NORWAY
Authors: Tengesdal S. et al.
Although PMR is associated with systemic inflammation, prolonged glucocorticoid therapy and often cardiovascular diseases, little is known about mortality of PMR compared to the general population.
296 patients of a county in Southern Norway were prospectively followed over 35 years to determine the mortality associated with PMR. Diagnosis was established using the criteria of Bird between 1987 and 1997. Patients were followed until death or December 31, 2021. Standard mortality ratios (SMR) were calculated using population data (age- and gender-matched). 200 (67.6%) were female, the mean age at diagnosis was 71.9 (SD 8.4). 277 patients (93.6%) were deceased at the censoring date of December 31, 2021. Mean observation time was 13.8 years (95% CI 12.8-14.7). The overall SMR was 1.05 (95% CI 0.93-1.18), for females 1.14 (95% CI 0.99- 1.31) and for men 0.91 (95% CI 0.73-1.11). There was no difference in survival between men and women.
In summary, the overall mortality was increased in diseased women compared to the general Norwegian population during the last decades of the study period. Furthermore, an increased mortality was observed in patients aged <60 at time of diagnosis. Thus, the data strongly suggest an important role of long-term glucocorticoid intake and indirectly argue for the prescription of steroid-sparing agents in treatment-resistant disease.