Predictors of glucocorticoid-free remission in patients with polymyalgia rheumatica treated with prednisolone.

ABSTRACT

AIM: This study aimed to identify predictive factors of glucocorticoid (GC)-free remission in patients with polymyalgia rheumatica (PMR) treated with prednisolone (PSL). METHOD: Among 75 PMR patients in our single-center registry, this retrospective study targeted 20 patients who achieved GC-free remission (Remission group) and 30 patients who continued treatment with PSL (PSL group) at 30 months from the initiation of PSL treatment (baseline). RESULTS: There was no significant difference between Remission and PSL groups in baseline demographics. C-reactive protein (CRP) decreased more rapidly at 1 and 3 months from baseline in the Remission group than in the PSL group (P = .013 and .046, respectively). Multivariate logistic regression analysis revealed that the normalization of CRP at 1 month was associated with the achievement of GC-free remission (odds ratio = 5.83, 95% CI = 1.28-26.51, P = .023). In addition, when CRP at 1 month was ≤ 0.17 mg/dL, as determined by receiver operating characteristic curve analysis, both the daily PSL dose and cumulative PSL dose were lower, and the rate of GC-free remission higher, at 30 months compared to when CRP at 1 month was > 0.17 mg/dL (P = .010, .049 and .004, respectively). CONCLUSION: The normalization of CRP within 1 month from baseline predicted GC-free remission in PMR patients treated with PSL, and resulted in a lower cumulative PSL dose.