To analyze the clinical course and duration of therapy in 28 patients with polymyalgia rheumatica (PMR) and/or temporal arteritis (TA) for identifying factors that influence prolonged steroid use and relapses.
28 cases of PMR and/or TA diagnosed from 1992 to 2001 were retrospectively studied in PUMC hospital. Patients were grouped according to the absence or presence of corticosteroid resistant and relapses.
Of 28 patients, 22 had pure PMR, 3 had both PMR and TA and 3 had pure TA. 15 patients received corticosteroid therapy and 13 had both corticosteroid and immunosuppressor therapy. The median duration was (25.5 +/- 24.0) months. Increase of white blood cell level and higher baseline erythrocyte sedimentation rate (ESR) were significant risk factors associated with corticosteroid resistant (P < 0.01). Quicker reduction of corticosteroid dose was associated with relapse (P < 0.05).
Patients with increase of white blood cell level and higher baseline erythrocyte sedimentation rate (ESR) are more likely to be resistant to corticosteroid therapy. Quicker reduction in corticosteroid is more likely to relapse. Immunosuppressor therapy should be added to patients who has corticosteroid resistant, and relapse or PMR associated with TA.