Prevalence and Predictors of Sub-Clinical GCA in PMR

[Joydeck]

Mercifully, I have been free of PMR since last Christmas and taking tablets just every second morning is a blessing. I thought this study interesting: rheumatologyadvisor.com/hom...

In particular:

Pooled prevalence was 20% in patients with PMR whose subclinical GCA was diagnosed by biopsy (CI, 7%-46%, I2=86%), 15% by ultrasonography (CI, 3%-50%, I2=86%), and 29% by PET/CT scans (CI, 13%-53%, I2=85%). The combined pooled prevalence of subclinical GCA in patients newly diagnosed with PMR was 23% (CI, 14%-36%, I2=84%).

Inflammatory back pain, lack of lower extremity pain, female sex, body temperature over 37.0°C, weight loss, thrombocyte count, and hemoglobin levels strongly predicted development of subclinical GCA. Conversely, C-reactive protein levels, erythrocyte sedimentation rate, leukocyte count, age, neck pain, pelvic girdle pain, and duration of morning stiffness did not predict development of subclinical GCA.

[PMRpro Ambassador]

The figure I have always registered was about 1 in 5 - and as the article says, those studies were often on a selected population - the PMR patients sent to a specialist rather than those who remain with their PCP.

It's a shame that PET-CT is so expensive and hard to access - in fact, not even sure a GP could refer for one even if there was better access/shorter waiting lists. A PET-CT done on every putative PMR patient before they get even 1 tablet of pred would be a fantastic way to go ...

Not going to happen though!

[PMR2011 in reply to PMRpro]

Agreed. I’ve shared this before. A study done using PET scans catching sub clinical GCA/LVV. Also shows the advantage of Actemra with this. This was the tipping point that had me decide to start Actemra and I’m very glad I did!

videocast.nih.gov/Summary

Great NIH talk on PET scanning and large vessel vasculitis. A bit technical but worth the watch.

[PMRpro Ambassador in reply to PMR2011]

Wanted to watch it - the link won't play! Is there a title so I could search separately?

[PMR2011 in reply to PMRpro]

Sorry, Try this:videocast.nih.gov/Summary.a...

[PMRpro Ambassador in reply to PMR2011]

Got it - hope it is as good as Grand Rounds usually is!!!!!! Love GR!

[Joydeck]

Yes, that link actually works.

My interest in the study lies in the list of symptoms indicative of sub-clinical GCA.