NICE recommendations for polymyalgia rheumatica - PMRGCAuk

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NICE recommendations for polymyalgia rheumatica

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41 Replies

We thought that this might be useful to people whose doctors claim they are "too young" to be given a PMR diagnosis:

cks.nice.org.uk/polymyalgia...

which says

"Polymyalgia rheumatica

Last revised in January 2019 Next planned review by December 2023

Scenario: Management of polymyalgia rheumatica

From age 40 years onwards."

There is a lot more on the link but anyone in the UK can access it for themselves. I won't quote it here as some is, shall we say, not entirely helpful, being more in line with theory than practice! Maybe by 2023 we'll have got through to them that 1-2 years duration is a decided underestimation!

Later in the article they say:

"Provide written information on PMR and regional patient support groups.

Polymyalgia Rheumatica and Giant Cell Arteritis (PMRGCA) UK (pmrgcauk.com) provide information packs, a helpline, newsletters, support groups, and a web forum for people with PMR and GCA."

and

"Arrange routine reviews one week after any change in dose and at least every 3 months in the first year following diagnosis.

Advise the person to arrange a review at other times:

Urgently, if they develop symptoms of GCA.

Routinely, if they develop symptoms of relapsing PMR, including proximal pain, fatigue, and morning stiffness."

These are all things your GP needs to be aware of - and, it appears, some rheumatologists who haven't read it either!

NICE: National Institute for Health and Clinical Excellence

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41 Replies
DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

Good - some progress then! Bit more required.

Are you going to pin?

PMRpro profile image
PMRproAmbassador in reply to DorsetLady

Now done - I'd done it as much to know where to find it if I needed it. It's thanks to Poopadoop - she found it!

HeronNS profile image
HeronNS

Only visible in the UK. :(

in reply to HeronNS

I have posted a lot of the content on another thread. Will edit it in... You should find on this thread.. .

healthunlocked.com/pmrgcauk...

Joydeck profile image
Joydeck in reply to

For the hell of it, I Googled a line of your posted content.

Yes, here in Australia, I can read the entire the Polymyalgia Rheumatica, 01 January 2019, NICE abstract but without formatting!

PMRpro profile image
PMRproAmbassador in reply to HeronNS

Yes, I can't see it either! I didn't want to put the whole thing here as it is quite long and people wouldn't bother with the original post if it were.

in reply to PMRpro

It is interesting to see what research they have used. I think putting it up for age change is the most important. Even if NICE don't always get it right, jinasc waS saying previously that the patient reps fought for the 40 onwards and like the post says... Its there for people whose Dr's say they are too young. I wonder why it's not available outside UK. Its used international research so its not a big secret!!

HeronNS profile image
HeronNS in reply to

This is what the page says:

CKS is only available in the UK

The NICE Clinical Knowledge Summaries (CKS) site is only available to users in the UK, Crown Dependencies and British Overseas Territories.

CKS content is produced by Clarity Informatics Limited. It is available to users outside the UK via subscription from the Prodigy website.

HeronNS profile image
HeronNS in reply to HeronNS

So I've run into this before, that NICE is not available outside the UK and territories. Probably something to do with it being government guidelines specific to the country.

in reply to HeronNS

I see. I presume they make money on subscription.

HeronNS profile image
HeronNS in reply to

Well whatever the website is, yes. Don't know who gets the money, whether gov or not. They won't get any from me. ;)

HeronNS profile image
HeronNS in reply to HeronNS

clarity.co.uk/prodigy/

in reply to HeronNS

It would be okay for you if it included commonwealth. 😉🤣🤣🤣

HeronNS profile image
HeronNS in reply to

You know the Commonweath was pretty much abandoned by UK when it joined EU! I remember my first visits to the UK I'd breeze right through Customs. Then with EU we Canadians were shuffled off into the queue with all the Americans arriving simultaneously on various flights, while visitors from the EU breezed right through!

in reply to HeronNS

You will be back on the quick side hopefully.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to

Maybe the Commonwealth will give us the cold shoulder! Hope not - need to breeze through NZ’s customs a few more times!

in reply to DorsetLady

🤣🤣🤣

HeronNS profile image
HeronNS in reply to

I suspect not. My passport used to say that a Canadian was a British subject but I can't imagine that has been the case for decades. I must have a look through the old ones and see where it changed. Possibly with Trudeau I and patriation of our constitution.

HeronNS profile image
HeronNS in reply to HeronNS

quora.com/Canada-is-part-of...

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to HeronNS

Probably all about to change methinks come the dreaded B!

PMRpro profile image
PMRproAmbassador in reply to

It is available - you can have it if you pay!!!

Jackoh profile image
Jackoh

Well at least they got a few things right! Hopefully by 2003 they will have progressed even further! 😜

PMRpro profile image
PMRproAmbassador in reply to Jackoh

2003??????

Jackoh profile image
Jackoh

Just checking if you’re on the ball- not!! I’m certainly not!! - 2023!! 😱

PMRpro profile image
PMRproAmbassador in reply to Jackoh

You know how after an accident or if you are showing dementia signs they ask you about date or day of the week and so on? I can only manage date if I have the computer on - and that doesn't help with day ...

in reply to Jackoh

😂😂😂

Jackoh profile image
Jackoh

Well there is no hope for me then - I had the computer/ iPad on. Just confirmed to me today that second day of reducing from 11.5 to 11mg was having more of an effect on me than I thought! 😳

in reply to Jackoh

I can't believe it's 20years since all that y2k stuff..... It seems like 5 years ago.

Jackoh profile image
Jackoh in reply to

It’s obviously seems like yesterday for me!! 😂😂

in reply to Jackoh

🤣😂🤣😂

tangocharlie profile image
tangocharlie

The address they give for the website is wrong, it's pmrgca.co.uk (not pmrgcauk.com)

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to tangocharlie

Just tried link - still takes you to correct site.

tangocharlie profile image
tangocharlie in reply to DorsetLady

That's OK then

tangocharlie profile image
tangocharlie

They admit relapses are common

Relapses are more likely to occur if corticosteroids are reduced or withdrawn too quickly [González-Gay, 2017; BMJ Best Practice, 2018].

Expert opinion in review articles is that:

When corticosteroids are tapered, disease flares may occur frequently (an average of 1–2 episodes per person-year) and are often manifested as new-onset or recurrent PMR [Weyand, 2014].

Yet at the beginning suggest a rapid tapering to be off within 6 months!

We are lions led by donkeys

PMRpro profile image
PMRproAmbassador in reply to tangocharlie

They believe that flares are inevitable. Like weight gain is inevitable.

We know better ;)

tangocharlie profile image
tangocharlie

I was talking to a woman recently who had had PMR, she said her cancer treatment was less complicated and more straightforward than the PMR experience!

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to tangocharlie

I think if you look at the difference in numbers between those diagnosed with cancer and those diagnosed with PMR in any one year - that would explain why the treatment for the former is better organised than the latter.

Plus of course there is much more research into cancer and it’s treatment etc.

tangocharlie profile image
tangocharlie in reply to DorsetLady

Yes of course I realise that, I can just understand her frustration!

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer in reply to tangocharlie

Can’t we all!

Although there is guidance out there, I think too many doctors “do their own thing” with PMR, whereas with cancer they don’t - or don’t dare to!

Telian profile image
Telian in reply to tangocharlie

My experience too - I have GCA and PMR - the cancer came 5 months into the AI and the flares that followed took a front seat every time. I've always said it, and that's not to say I didn't feel bad on the C treatments either.

Following C surgery I knew I was having a flare - the nurses doctors thought I was unwell from the surgery - only after insistence from my son did the ward contact Rheumie - who adjusted pred and I began to improve. I was in for 4 days instead of 1 because of it.

Clearly the wonderful nurses and doctors on the ward didn't understand the effects of the GCA/PMR.

SuziCutie profile image
SuziCutie

Thanks for sharing this. I intend printing it out for future reference.

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