• Dtsch Arztebl Int · Jun 2022

    Review

    Polymyalgia Rheumatica-Sex-Specific Epidemiology, Diagnostic and Therapeutic Approach, and Medical Care.

    • Miriam Giovanna Colombo, Anna-Jasmin Wetzel, Hannah Haumann, Simon Dally, Gudula Kirtschig, and Stefanie Joos.
    • Institute for General Practice and Inter - professional Care, University Hospital Tübingen; Department of Analytics and Data Science, AOK Baden-Württemberg, Stuttgart; Medical Division, AOK Baden-Württemberg, Stuttgart.
    • Dtsch Arztebl Int. 2022 Jun 17; 119 (24): 411417411-417.

    BackgroundPolymyalgia rheumatica (PMR) is among the most common inflammatory rheumatic diseases in older adults. Presumed risk factors include female sex, previous infections, and genetic factors. No epidemiological data on PMR in Germany have been available until now.MethodsThis review is based on publications retrieved by a selective literature search in PubMed. Moreover, the administrative incidence and prevalence of PMR in the years 2011-2019 was determined from data of the AOK Baden-Württemberg statutory health insurance carrier for insurees aged 40 and older. In addition, we quantified the number of consultations with physicians involved in the diagnosis.ResultsThe annual age- and sex-standardized incidence and prevalence of PMR from 2011 to 2019 were 18.6/100 000 persons and 138.8/100 000 persons, respectively. The incidence was higher in women than in men (21.8/100 000 vs. 12.8/100 000 persons per year). 60% of the cases were diagnosed in primary care practices. The treatment of PMR with orally administered glucocorticoids usually results in a treatment response within a few days to weeks. Approximately 43% of patients experience recurrent symptoms within a year, requiring adjustment of the glucocorticoid dose. For older patients with impaired physical ability, additional non-pharmacological treatment with exercise programs plays an important role.ConclusionPMR usually takes an uncomplicated course under treatment and can be managed in primary care, but these patients are often multimorbid and require frequent follow-up. Along with research on the etiology of the disease, further studies are needed to identify the risk factors for a chronic course and to evaluate the potential effects of non-pharmacological measures.

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