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KMID : 0191120120270010022
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Journal of Korean Medical Science
2012 Volume.27 No. 1 p.22 ~ p.26
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Induction of Remission is Difficult due to Frequent Relapse during Tapering Steroids in Korean Patients with Polymyalgia Rheumatica
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Kim Hyoun-Ah
Lee Ji-Soo
Ha You-Jung
Kim Sang-Hyon
Lee Chan-Hee
Choi Hyo-Jin
Baek Han-Joo
Lim Mie-Jin
Park Won
Choi Sung-iae
Hong Yeon-Sik
Lee Yoo-Hyun
Koh Bo-Ram
Suh Chang-Hee
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Abstract
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Polymyalgia rheumatica is an inflammatory disease affecting elderly and involving the shoulder and pelvic girdles. No epidemiological study of polymyalgia rheumatica was conducted in Korea. We retrospectively evaluated patients with polymyalgia rheumatica followed up at the rheumatology clinics of 10 tertiary hospitals. In total 51 patients, 36 patients (70.6%) were female. Age at disease onset was 67.4 yr. Twenty-three patients (45.1%) developed polymyalgia rheumatica in winter. Shoulder girdle ache was observed in 45 patients (90%) and elevated erythrocyte sedimentation rate (> 40 mm/h) in 49 patients (96.1%). Initial steroid dose was 23.3 mg/d prednisolone equivalent. Time to normal erythrocyte sedimentation rate was 4.1 months. Only 8 patients (15.7%) achieved remission. Among 41 patients followed up, 28 patients (68.3%) had flare at least once. Number of flares was 1.5 ± 1.6. The frequency of flare was significantly lower in patients with remission (P = 0.02). In Korea, polymyalgia rheumatica commonly develops during winter. Initial response to steroid is fairly good, but the prognosis is not benign because remission is rare with frequent relapse requiring long-term steroid treatment.
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KEYWORD
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Polymyalgia Rheumatica, Symptoms, Treatment, Steroids, Remission, Prognosis
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