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

[41] POLYMYALGIA RHEUMATICA AND GIANT-CELL ARTERITIS
HEALEY, LA
WILSKE, KR
WESTERN JOURNAL OF MEDICINE, 1984, 141 (01): : 64 - 67
[42] POLYMYALGIA RHEUMATICA AND GIANT-CELL ARTERITIS
MEDENICA, R
EPINEY, J
MARTIN, E
SCHWEIZERISCHE MEDIZINISCHE WOCHENSCHRIFT, 1971, 101 (16) : 557 - &
[43] Polymyalgia rheumatica and giant-cell arteritis
Salvarani, Carlo
Cantini, Fabrizio
Hunder, Gene G.
LANCET, 2008, 372 (9634): : 234 - 245
[44] Treatment of giant cell arteritis and polymyalgia rheumatica
Horvath, L.
Hellmich, B.
ZEITSCHRIFT FUR RHEUMATOLOGIE, 2020, 79 (02): : 175 - 185
[45] POLYMYALGIA RHEUMATICA AND GIANT-CELL ARTERITIS
ORTEL, RW
WEST VIRGINIA MEDICAL JOURNAL, 1981, 77 (05) : 116 - 121
[46] TREAT-TO-TARGET RECOMMENDATIONS IN GIANT CELL ARTERITIS AND POLYMYALGIA RHEUMATICA
Dejaco, C.
Kerschbaumer, A.
Aletaha, D.
Bond, M.
Hysa, E.
Camellino, D.
Ehlers, L.
Abril, A.
Appenzeller, S.
Cid, M. C.
Dasgupta, B.
Duftner, C.
Grayson, P.
Hellmich, B.
Hocevar, A.
Kermani, T.
Matteson, E.
Mollan, S.
Neill, L.
Ponte, C.
Salvarani, C.
Sattui, S. E.
Schmidt, W. A.
Seo, P.
Smolen, J.
Thiel, J.
Toro Gutierrez, C.
Whitlock, M.
Buttgereit, F.
ANNALS OF THE RHEUMATIC DISEASES, 2023, 82 : 643 - 644
[47] Treat-to-target recommendations in giant cell arteritis and polymyalgia rheumatica
Dejaco, Christian
Kerschbaumer, Andreas
Aletaha, Daniel
Bond, Milena
Hysa, Elvis
Camellino, Dario
Ehlers, Lisa
Abril, Andy
Appenzeller, Simone
Cid, Maria C.
Dasgupta, Bhaskar
Duftner, Christina
Grayson, Peter C.
Hellmich, Bernhard
Hocvar, Alojzija
Kermani, Tanaz A.
Matteson, Eric L.
Mollan, Susan P.
Neill, Lorna
Ponte, Cristina
Salvarani, Carlo
Sattui, Sebastian Eduardo
Schmidt, Wolfgang A.
Seo, Philip
Smolen, Josef S.
Thiel, Jens
Toro-Gutierrez, Carlos Enrique
Whitlock, Madeline
Buttgereit, Frank
ANNALS OF THE RHEUMATIC DISEASES, 2024, 83 (01) : 48 - 57
[48] Giant cell arteritis and polymyalgia rheumatica: Clues to early diagnosis
Dwolatzky, T
Sonnenblick, M
Nesher, G
GERIATRICS, 1997, 52 (06) : 38 - &
[49] The spectrum of giant cell arteritis and polymyalgia rheumatica: a longitudinal prospective study to assess for subclinical giant cell arteritis in new onset polymyalgia rheumatica
El Miedany, Yasser
El Gaafary, Maha
Toth, Mathias
Bahlas, Sami
Hassan, Waleed
Mahran, Safaa
Abu-Zaid, Mohammed Hassan
El Miedany, Ali
Elwakil, Walaa
EGYPTIAN RHEUMATOLOGY AND REHABILITATION, 2025, 52 (01)
[50] GIANT-CELL ARTERITIS - POLYMYALGIA RHEUMATICA AND TEMPORAL ARTERITIS
VILASECA, J
VIVANCOS, JL
MEDICINA CLINICA, 1985, 85 (07): : 290 - 297

← 1 2 3 4 5 →