Anyone have thoughts on this research article?

[kimsaunsc]

Just read article at ncbi.nlm.nih.gov. ( can’t seem to get the link copied here)

Would love to read your comments on this.

[PMRpro Ambassador]

Unless you can write out the title and author of the actual article can't help I fear! There are thousands and thousands of articles under that bit!

[kimsaunsc in reply to PMRpro]

PMR: Observations of disease evolution without corticosteroid treatment. Author is Arthur Brawer.

[PMRpro Ambassador in reply to kimsaunsc]

I have discussed it with top UK experts in PMR and they are not impressed by it. As HeronNS says, Dove Press at that time was criticised for accepting rather unreliable work without any rigorous peer review. If you look at the times from submission to acceptance and acceptance to publication it is obvious there was NO peer review, never mind of a rigorous sort!

It is certainly work that hasn't been reproduced by anyone else and there isn't even much anecdotal mention in the literature of success with hydroxychloroquine. It has its place, usually in lupus, but no history in PMR. It isn't even used a lot in RA, which is what he suggests.

It is all very well to say that PMR goes away on its own - it does for most people but in the meantime they may be severely disabled and in a lot of pain. And there is no fixed duration - I had had PMR symptoms for 5 years before 15mg of pred brought about a miracle in 6 hours. I still have it. There are quite a few people who experienced difficulty in getting an early diagnosis and whose PMR has subsequently proven difficult to manage and lasted a long time. It is becoming clear from various studies that there are several versions of PMR - which obviously complicates the situation.

Given the opinion is that not managing PMR increases the risk of it progressing to LVV and/or GCA, it seems to me to be irresponsible to leave patients effectively untreated on NSAIDs which generally do not have much, if any, effect on PMR symptoms. The unmanaged inflammation is also doing damage to the tissues and long term even low level inflammation is thought to contribute to the development of some cancers and cardiovascular disease. And frankly - after 5 years of not having my PMR treated, NSAIDs did nothing, I'm just glad he wasn't my doctor - deliberately withholding treatment is rather cruel.

[kimsaunsc in reply to PMRpro]

Thank you for the response and good information. I wondered who would possibly volunteer to not be treated with pred! I couldn’t imagine living in that much pain.

[PMRpro Ambassador in reply to kimsaunsc]

Having done it - not from choice - me neither ...

[HeronNS]

ncbi.nlm.nih.gov/pmc/articl...

I haven't taken time to look at it. I note it is DovePress which I think doesn't have a good reputation regarding scholarly rigor, but I don't really know.