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Polymyalgia rheumatica

Sist revidert:
Sist revidert av:


Definisjon:
Er en inflammatorisk revmatisk tilstand. Ukjent årsak
Forekomst:
I Norge hos ca. 110 per 100 000 per år. Vanligvis over 50 år. Forekommer særlig hyppig i Skandinavia
Symptomer:
De mest fremtredende symptomene er bilaterale skulder- og/eller bekkensmerter, morgenstivhet og generell sykdomsfølelse.
Funn:
Få typiske funn, men ofte ømhet i muskulaturen 
Diagnostikk:
Akutt fase reaktanter som SR og CRP er ofte forhøyet
Behandling:
Kortikosteroider. Vanlig startdose er 12,5-25 mg prednisolon daglig
  1. Weyand CM, Goronzy JJ. Clinical practice. Giant-cell arteritis and polymyalgia rheumatica. N Engl J Med. 2014 Jul 3;371(1):50-7. PMID: 24988557. PubMed  
  2. Rosenberg H, Halman S, Yadav K. Polymyalgia rheumatica. CMAJ. 2021 Nov 22;193(46):E1770. PMID: 34810164 PubMed  
  3. González-Gay MA, Matteson EL, Castañeda S. Polymyalgia rheumatica. Lancet. 2017 Oct 7;390(10103):1700-1712. Epub 2017 Jul 31. PMID: 28774422. PubMed  
  4. Dasgupta B, Borg FA, Hassan N, et al. BSR and BHPR guidelines for the management of polymyalgia rheumatica. Rheumatology 2010; 49: 186-90. Rheumatology  
  5. Dasgupta B, Cimmino MA, Maradit-Kremers H et al. 2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheum 2012; 65: 943-54. www.ncbi.nlm.nih.gov  
  6. Buttgereit F, Dejaco C, Matteson EL, et al.. polymyalgia rheumatica and giant cell arteritis: a systematic review. JAMA 2016;315:2442–58. PMID: 27299619 PubMed  
  7. Gran JT, Myklebust G. Incidence and clinical characteristics of peripheral arthritis in polymyalgia rheumatica and temporal arteritis. Rheumatology 2000; 39: 283-7. Rheumatology  
  8. Gilden D, White T, Khmeleva N, et al. Prevalence and distribution of VZV in temporal arteries of patients with giant cell arteritis. Neurology 2015. DOI: 10.1212/WNL.0000000000001409 DOI  
  9. Soriano A, Verrecchia E, Marinaro A, et al. Giant cell arteritis and polymyalgia rheumatica after influenza vaccination: report of 10 cases and review of literature. Lupus 2012; 21: 153-7. PubMed  
  10. Ezeonyeji AN, Borg FA, Dasgupta B. Delays in recognition and management of giant cell arteritis: results from a retrospective audit. Clin Rheumatol. 2011;30(2):259–262.
  11. Kreiner F, Langberg H, Galbo H. Increased muscle interstitial levels of inflammatory cytokines in polymyalgia rheumatica. Arthritis Rheum. 2010;62(12):3768–3775.
  12. González-Gay MA, Pina T. Giant cell arteritis and polymyalgia rheumatica: an update. Curr Rheumatol Rep. 2015 Feb;17(2):6. PMID: 25618572 PubMed  
  13. Macchioni P1, Boiardi L, Catanoso M, Pazzola G, Salvarani C. Performance of the new 2012 EULAR/ACR classification criteria for polymyalgia rheumatica: comparison with the previous criteria in a single-centre study. Ann Rheum Dis 2014; 73: 1190-3. pmid:24297384 PubMed  
  14. Ozen G, Inanc N, Unal AU, et al. Assessment of the New 2012 EULAR/ACR Clinical Classification Criteria for Polymyalgia Rheumatica: A Prospective Multicenter Study. J Rheumatol 2016. pmid:26834222 PubMed  
  15. Mackie SL, Hensor EM, Haugeberg G, Bhakta B, Pease CT. Can the prognosis of polymyalgia rheumatica be predicted at disease onset? Results from a 5-year prospective study. Rheumatology (Oxford). 2010;49(4):716–722.
  16. Breuer GS, Nesher G. What does imaging tell us about polymyalgia rheumatica? Rheumatology 2011; 51: 5-6. Rheumatology  
  17. Dejaco C, Singh YP, Perel P, et al. 2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis. 2015; 74(10): 1799-807. Pmid: 26359488.
  18. Hernández-Rodríguez J, Cid MC, López-Soto A, Espigol-Frigolé G, Bosch X. Treatment of polymyalgia rheumatica: a systematic review. Arch Intern Med. 2009;169(20):1839–1850.
  19. Allen CS, Yeung JH, Vandermeer B, et al. Bisphosphonates for steroid-induced osteoporosis. Cochrane Database Syst Rev. 2016 Oct 5;10:CD001347. pmid: 27706804 PubMed  
  20. Rosen HN, Saag KG. Prevention and treatment of glucocorticoid-induced osteoporosis. UpToDate. Sist revidert juni 2015. www.uptodate.com  
  21. Marsman DE, den Broeder N, van den Hoogen FHJ, et al. Efficacy of rituximab in patients with polymyalgia rheumatica: a double-blind, randomised, placebo-controlled, proof-of-concept trial. Lancet Rheumatol 2021. doi:10.1016/S2665-9913(21)00245-9 DOI  
  22. Kermani TA, Warrington KJ, Cuthbertson D, et al. Disease relapses among patients with giant cell arteritis: A prospective, longitudinal cohort study. J Rheumatol 2015; 42:1213. doi: 10.3899/jrheum.141347 DOI  
  23. Dejaco C, Duftner C, Cimmino MA, Dasgupta B, Salvarani C, Crowson CS, Maradit-Kremers H, Hutchings A, Matteson EL, Schirmer M; International Work Group for PMR and GCA. Definition of remission and relapse in polymyalgia rheumatica: data from a literature search compared with a Delphi-based expert consensus. Ann Rheum Dis. 2011;70:447–453
  24. Wu J, Keeley A, Mallen C et al. Incidence of infections associated with oral glucocorticoid dose in people diagnosed with polymyalgia rheumatica or giant cell arteritis: a cohort study in England. CMAJ 2019; 191: E680-8. pmid:31235489 PubMed  
  25. Faurschou M, Ahlstrom MG, Lindhardsen J, et al. Risk of Diabetes mellitus among patients diagnosed with giant cell arteritis or granulomatosis with polyangiitis: Comparison with the general population. J Rheumatol. 2016 . PMID:27744394 PubMed  
  26. Hancock AT, Mallen CD, Muller S, et al. Risk of vascular events in patients with polymyalgia rheumatica. CMAJ. 2014 Jul 28.
  27. Pujades-Rodriguez M, Duyx B, Thomas SL, et al. Associations between polymyalgia rheumatica and giant cell arteritis and 12 cardiovascular diseases. Heart 2016. doi:10.1136/heartjnl-2015-308514 DOI  
  28. Muller S, Hider SL, Belcher J, et al. Is cancer associated with polymyalgia rheumatica? A cohort study in the general practice research database. Ann Rheum Dis 2014; 73: 1769:73. doi:10.1136/annrheumdis-2013-203465 DOI  
  29. Dasgupta B, Borg FA, Hassan N, et al.; BSR and BHPR Standards, Guidelines and Audit Working Group. BSR and BHPR guidelines for the management of polymyalgia rheumatica. Rheumatology (Oxford). 2010;49(1):186–190.
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Gunnar Husby, professor i revmatologi, Oslo Sanitetsforenings Revmatismesykehus, Universitetet i Oslo og Rikshospitalet, Oslo