Symptom Severity and Glucocorticoid Dosing in Patients With Polymyalgia Rheumatica and Obesity.

IF 3.6 2区 医学 Q2 RHEUMATOLOGY
Marco A Cimmino, Cynthia S Crowson, Bhaskar Dasgupta, Michael Schirmer, Christian Dejaco, Carlo Salvarani, Eric L Matteson, Dario Camellino
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引用次数: 0

Abstract

Objective: Polymyalgia rheumatica (PMR) is an inflammatory disorder of the elderly characterized by girdle pain and stiffness. Obesity has an influence on disease activity and outcome in rheumatic diseases like osteoarthritis and rheumatoid arthritis. We aimed to investigate the relationship between high BMI and the severity and outcome of PMR, which is incompletely understood.

Methods: In a post hoc analysis, 83 patients with recent-onset PMR were studied over 6 months using clinical examination, laboratory evaluation, and girdle ultrasound (US). The modified Health Assessment Questionnaire (mHAQ), 36-item Short Form Health Survey (SF-36), and PMR visual analog scale (VAS) scores, as well as prednisone therapy data, were recorded. Patients were grouped according to their BMI.

Results: At baseline, the 12 patients with obesity had significantly more shoulder pain (P = 0.03), global pain (P = 0.03), PMR VAS (P < 0.01), and fatigue (P = 0.03); higher mHAQ (P = 0.01); and lower SF-36 physical component summary (P = 0.048) and SF-36 pain index (P < 0.001). The mean initial prednisone dose was similar among groups, but patients with obesity received a lower dose/kg (1.9 [SD 0.7] mg vs 2.2 [SD 0.7] mg; P < 0.01). At 6 months, patients with obesity were being treated with higher mean daily prednisone doses (8.5 [SD 3.2] mg/d vs 6.2 [SD 5.2] mg/d; P = 0.02), and 40% of them were receiving higher daily prednisone doses than the standard protocol compared with 14% patients without obesity (P = 0.048). Clinical features, laboratory results, and US results were similar between patients with and without obesity.

Conclusion: Obesity affects both symptom severity and prednisone utilization in patients with PMR. The reason for this may relate to different subjective pain perception rather than increased inflammation in patients with obesity. BMI should be considered when interpreting symptoms in patients with PMR and deciding their prednisone doses.

肥胖的多发性风湿病患者在发病时会有更多的疼痛和残疾,并且需要更大剂量的糖皮质激素。
目的:多发性风湿痛(PMR)是一种以腰部疼痛和僵硬为特征的老年炎症性疾病。肥胖对骨关节炎和类风湿性关节炎等风湿性疾病的病情活动和预后有影响,但其与多发性风湿痛的严重程度和预后的关系尚不清楚:在一项事后分析中,研究人员对 83 名近期发病的 PMR 患者进行了为期 6 个月的临床检查、实验室评估和腰部超声波检查。记录了MHAQ、简表36(SF36)、PMR-VAS以及泼尼松(PDN)治疗情况。结果:基线时,12 名肥胖患者的肩部疼痛(P=0.03)、全身疼痛(P=0.03)、PMR VAS(P=0.03)和泼尼松治疗(PDN)均显著增加。其原因可能与肥胖患者对疼痛的主观感受不同有关,而非炎症加重。在解释 PMR 患者的症状和决定其 PDN 剂量时,应考虑体重指数。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Rheumatology
Journal of Rheumatology 医学-风湿病学
CiteScore
6.50
自引率
5.10%
发文量
285
审稿时长
1 months
期刊介绍: The Journal of Rheumatology is a monthly international serial edited by Earl D. Silverman. The Journal features research articles on clinical subjects from scientists working in rheumatology and related fields, as well as proceedings of meetings as supplements to regular issues. Highlights of our 41 years serving Rheumatology include: groundbreaking and provocative editorials such as "Inverting the Pyramid," renowned Pediatric Rheumatology, proceedings of OMERACT and the Canadian Rheumatology Association, Cochrane Musculoskeletal Reviews, and supplements on emerging therapies.
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