Recommendations for early referral of individuals with suspected polymyalgia rheumatica: an initiative from the international giant cell arteritis and polymyalgia rheumatica study group

被引：18

作者：

Keller, Kresten Krarup ^{[1
,2
]}

Mukhtyar, Chetan B. ^{[3
]}

Nielsen, Andreas Wiggers ^{[1
,2
]}

Hemmig, Andrea Katharina ^{[4
]}

Mackie, Sarah Louise ^{[5
,6
]}

Sattui, Sebastian Eduardo ^{[7
]}

Hauge, Ellen-Margrethe ^{[1
,2
]}

Dua, Anisha ^{[8
]}

Helliwell, Toby ^{[9
]}

Neill, Lorna ^{[10
]}

Blockmans, Daniel ^{[11
,12
]}

Devauchelle-Pensec, Valerie ^{[13
,14
]}

Hayes, Eric ^{[1
]}

Venneboer, Annett Jansen ^{[15
]}

Monti, Sara ^{[16
]}

Ponte, Cristina ^{[17
,18
]}

De Miguel, Eugenio ^{[19
]}

Matza, Mark ^{[20
]}

Warrington, Kenneth J. ^{[21
]}

Byram, Kevin ^{[22
]}

Yaseen, Kinanah ^{[23
]}

Peoples, Christine ^{[7
]}

Putman, Michael ^{[24
]}

Lally, Lindsay ^{[25
]}

Finikiotis, Michael ^{[26
]}

Appenzeller, Simone ^{[27
]}

Caramori, Ugo ^{[28
]}

Toro-Gutierrez, Carlos Enrique ^{[29
]}

Backhouse, Elisabeth

Oviedo, Maria Camila Guerrero ^{[30
]}

Pimentel-Quiroz, Victor Roman ^{[31
,32
]}

Keen, Helen Isobel ^{[33
]}

Owen, Claire Elizabeth ^{[34
,35
]}

Daikeler, Thomas ^{[4
]}

de Thurah, Annette ^{[1
,2
]}

Schmidt, Wolfgang A. ^{[36
]}

Brouwer, Elisabeth ^{[15
]}

Dejaco, Christian ^{[37
,38
]}

机构：

[1] Aarhus Univ Hosp, Dept Rheumatol, Aarhus, Denmark

[2] Aarhus Univ, Dept Clin Med, Aarhus, Denmark

[3] Norfolk & Norwich Univ Hosp NHS Trust, Rheumatol Dept, Vasculitis Serv, Norwich, England

[4] Univ Hosp, Clin Rheumatol, Basel, Switzerland

[5] Univ Leeds, Leeds Inst Rheumat & Musculoskeletal Med, Leeds, England

[6] Leeds Teaching Hosp NHS Trust, Leeds Biomed Res Ctr, Leeds, England

[7] Univ Pittsburgh, Div Rheumatol & Clin Immunol, Med, Med Ctr, Pittsburgh, PA USA

[8] Northwestern Univ, Feinberg Sch Med, Chicago, IL USA

[9] Univ Staffordshire, Sch Med, Stafford, England

[10] Patient Char Polymyalgia Rheumat & Giant Cell Art, Dundee, Scotland

[11] Univ Hosp Leuven, Lab Clin Infect & Inflammatory Disorders, Res Dept Microbiol & Immunol, Clin Dept,Gen Internal Med Dept, Leuven, Belgium

[12] Univ Ziekenhuis Gasthuisberg, Leuven, Belgium

[13] Brest Univ, Rheumatol, Brest, France

[14] La Cavale Blanche Hosp, Brest, France

[15] Univ Med Ctr Groningen, Dept Rheumatol & Clin Immunol, Groningen, Netherlands

[16] Fdn IRCCS Policlin San Matteo Pavia, Div Rheumatol, Rheumatol, Pavia, Italy

[17] Ctr Hosp Univ Lisboa Norte EPE, Rheumatol, Lisbon, Portugal

[18] Inst Med Mol, Rheumatol Res Unit, Lisbon, Portugal

[19] Hosp Univ La Paz, Madrid, Spain

[20] Massachusetts Gen Hosp, Boston, MA USA

[21] Mayo Clin, Rheumatol, Rochester, MN USA

[22] Vanderbilt Hlth, Vanderbilt Rheumatol, Nashville, TN USA

[23] Cleveland Clin, Orthoped & Rheumatol Inst, Cleveland, OH USA

[24] Med Coll Wisconsin, Dept Med, Milwaukee, WI USA

[25] Hosp Special Surg, New York, NY USA

[26] Univ Pittsburgh, Med Ctr Hlth Syst, Pittsburgh, PA USA

[27] Univ Estadual Campinas, Fac Ciencias Med, Dept Clin Med, Campinas, Brazil

[28] Univ Estadual Campinas, Dept Publ Hlth, Campinas, Brazil

[29] Pontificia Univ Javeriana Cali, Reference Ctr Osteoporosis Rheumatol & Dermatol, Fac Ciencias Salud, Cali, Colombia

[30] Clin Imbanaco, Cali, Colombia

[31] Hosp Nivel IV Guillermo Almenara Irigoyen, Rheumatol, Lima, Peru

[32] Univ Cient Sur, Sch Med, Lima, Peru

[33] UWA, Med & Pharmacol, Perth, Australia

[34] Austin Hlth, Rheumatol, Heidelberg, Vic, Australia

[35] Univ Melbourne, Med, Melbourne, Vic, Australia

[36] Immanuel Krankenhaus GmbH, Rheumatol, Berlin, Germany

[37] Brunico Hosp, Rheumatol, Brunico, Italy

[38] Med Univ Graz, Rheumatol, Graz, Austria

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2023年

关键词：

Polymyalgia Rheumatica; Vasculitis; Giant Cell Arteritis; CLASSIFICATION CRITERIA; RHEUMATISM/AMERICAN COLLEGE; EUROPEAN LEAGUE; DIAGNOSIS; ARTHRITIS; THERAPY; TOCILIZUMAB; MANAGEMENT; SYMPTOMS; PEOPLE;

D O I：

10.1136/ard-2023-225134

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To develop international consensus-based recommendations for early referral of individuals with suspected polymyalgia rheumatica (PMR).Methods A task force including 29 rheumatologists/internists, 4 general practitioners, 4 patients and a healthcare professional emerged from the international giant cell arteritis and PMR study group. The task force supplied clinical questions, subsequently transformed into Population, Intervention, Comparator, Outcome format. A systematic literature review was conducted followed by online meetings to formulate and vote on final recommendations. Levels of evidence (LOE) (1-5 scale) and agreement (LOA) (0-10 scale) were evaluated.Results Two overarching principles and five recommendations were developed. LOE was 4-5 and LOA ranged between 8.5 and 9.7. The recommendations suggest that (1) each individual with suspected or recently diagnosed PMR should be considered for specialist evaluation, (2) before referring an individual with suspected PMR to specialist care, a thorough history and clinical examination should be performed and preferably complemented with urgent basic laboratory investigations, (3) individuals with suspected PMR with severe symptoms should be referred for specialist evaluation using rapid access strategies, (4) in individuals with suspected PMR who are referred via rapid access, the commencement of glucocorticoid therapy should be deferred until after specialist evaluation and (5) individuals diagnosed with PMR in specialist care with a good initial response to glucocorticoids and a low risk of glucocorticoid related adverse events can be managed in primary care.Conclusions These are the first international recommendations for referral of individuals with suspected PMR, which complement the European Alliance of Associations for Rheumatology/American College of Rheumatology management guidelines for established PMR.

引用

页数：7

共 50 条

[1] Recommendations for Early Referral of Patients with Suspected Polymyalgia Rheumatica: An Initiative from the International Giant Cell Arteritis and Polymyalgia Rheumatica Study Group
Keller, Kresten
Mukhtyar, Chetan
Nielsen, Andreas Wiggers
Hemmig, Andrea
Mackie, Sarah
Sattui, Sebastian
Hauge, Ellen Margrethe
Dua, Anisha
Helliwell, Toby
Neil, Lorna
Blockmans, Daniel
Devauchelle, Valerie
Hayes, Eric
Venneboer, Annett Jansen
Monti, Sara
Ponte, Cristina
De Miguel, Eugenio
Matza, Mark
Warrington, Kenneth
Byram, Kevin
Yaseen, Kinanah
Peoples, Christine
Putman, Mike
Lally, Lindsay
Finikiotis, Michael
Appenzeller, Simone
Carmori, Ugo
Toro Gutierrez, Carlos Enrique
Backhouse, Elisabeth
Camila Guerrero, Maria
Pimentel-Quiroz, Victor
Keen, Helen
Owen, Claire
Daikeler, Thomas
De Thurah, Annette
Schmidt, Wolfgang
Brouwer, Elisabeth
Dejaco, Christian
ARTHRITIS & RHEUMATOLOGY, 2023, 75 : 4745 - 4747
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[10] GIANT CELL ARTERITIS IN POLYMYALGIA RHEUMATICA
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