Vasculitis & polymyalgia rheumatica
The effect of prednisolone initiation and short-term discontinuation on the clinical assessment of polymyalgia rheumatica
Authors' conclusion
This study shows that clinically assessing PMR becomes challenging after prednisolone initiation, and that short-term prednisolone discontinuation does not improve clinical assessment to pre-treatment levels.
Study context
- Population
- Treatment-naïve patients with PMR and non-PMR; 198 case report forms (CRFs) rated by six blinded rheumatologists198 CRFs · Treatment-naïve patients with PMR 66 · non-PMR 27
- Participants
- 66 / 27 / 57 / 48
- Comparison
- Clinical assessment of PMR at baseline vs after 8 weeks of prednisolone vs after short-term prednisolone discontinuation at week 10
- PMRn = 66
- Non-PMRn = 27reference
- After prednisolone initiationn = 57
- After short-term discontinuationn = 48
- Outcome
- Rated probability of a PMR diagnosis (0–10) and classification as PMR or non-PMR
Methodological detailsprospective cohort, case report forms, assessors blinded to diagnosis, prednisolone treatment and visit timing
- Prospective cohort
- Case report forms
- Assessors blinded to diagnosis, prednisolone treatment and visit timing
Performance
As reported in the abstract
| Test or model | Value | Median probability in non-PMR | Sensitivity | Specificity |
|---|---|---|---|---|
| Baseline | median 7.8 | 2.8 | 85.9% | 82.7% |
| After prednisolone initiation | median 1.0 | 3.5% | ||
| After short-term discontinuation | median 2.3 | 25% |
Value
Baselinemedian 7.8
After prednisolone initiationmedian 1.0
After short-term discontinuationmedian 2.3
Median probability in non-PMR
Baseline2.8
After prednisolone initiation— not stated in the abstract
After short-term discontinuation— not stated in the abstract
Sensitivity
Baseline85.9%
After prednisolone initiation3.5%
After short-term discontinuation25%
Specificity
Baseline82.7%
After prednisolone initiation— not stated in the abstract
After short-term discontinuation— not stated in the abstract
Original publication
The effect of prednisolone initiation and short-term discontinuation on the clinical assessment of polymyalgia rheumatica. Rheumatology (Oxford). Published 25 March 2025. doi:10.
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