Patient-reported outcome measures in incident Polymyalgia Rheumatica: Changes after treatment initiation, short-term glucocorticoid discontinuation, and at one-year follow-up

OBJECTIVES: The role of patient-reported outcomes measures (PROMs) in polymyalgia rheumatica (PMR) remains scarcely studied. This study evaluated PROMs at baseline, after glucocorticoid (GC) initiation, following short-term GC discontinuation, and one year after diagnosis in patients with PMR. METHODS: A prospective cohort of patients suspected of PMR was enrolled from three Danish rheumatology departments. Patients with PMR initiated GC treatment. Clinical assessment, including physicians' global assessment of disease activity (PhGA), laboratory tests, and PROMs, were performed at baseline, week 8, week 10 after short-term GC discontinuation, and after one year. PROMs comprised different pain visual analogue scales (VAS), PMR VAS, morning stiffness duration, and 36-item Short-Form Survey (SF-36). RESULTS: A total of 60 patients with PMR, without concomitant or late-onset giant cell arteritis, were included. All PROMs improved from baseline to week 8 (p < 0.001), with an average decrease of 59 mm in VAS scores. From week 8 to 10, all PROMs except the SF-36 mental component score worsened (p < 0.01). Pain VAS and PMR VAS were higher after one year than at week 8 (p < 0.01). Patients with relapse at week 10 had higher VAS scores and lower SF-36 physical subscale scores at week 8 and 10 (p < 0.05) compared with patients without relapse. PhGA correlated strongly with PMR VAS, shoulder pain, and global pain (r > 0.75, p < 0.01). CONCLUSION: PROMs, particularly pain-related VAS scores, may predict relapse and guide individualised tapering strategies in patients with PMR. The strong correlations between PhGA and PROMs highlight the clinical relevance of integrating PROMs into routine monitoring.