Withdrawal of Glucocorticoid Therapy is Difficult in Women with Polymyalgia Rheumatica: An Observational Study.

ABSTRACT

OBJECTIVE: A total of 105 patients (64 women) who were started on glucocorticoid (GC) treatment for polymyalgia rheumatica (PMR) and/or remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome at Ikeda City Hospital from July 2004 to December 2019 were reviewed (PMR 81, overlap 20, pure RS3PE syndrome 4). Then, 32 cases that had stopped GC and 17 cases that had continued GC for 7.5 years or longer were evaluated (womenmen, stopped GC 1220, continued GC 134, respectively) (PMRoverlappure RS3PE syndrome, stopped GC 2660, continued GC 1421, respectively). METHODS: The GC continuation rate in all patients was examined using the Kaplan-Meier method. The following were compared between the two groups age at starting GC; sex; erythrocyte sedimentation rate, C-reactive protein, hemoglobin, ferritin, aspartate aminotransferase, and alanine aminotransferase before starting GC; days from the onset of symptoms to GC initiation; GC maximum dose; GC dose half a year after its start; presence of relapse; and existence of concomitant malignant disease. RESULTS: The GC continuation rate 7.5 years after GC initiation was 52.5%, higher in women (69.2%), than in men (27.1%). The rates then remained unchanged for 15 years. Hemoglobin was high, and relapse was uncommon in the group that stopped GC. There were no differences in other items. CONCLUSION: It is difficult to stop GC therapy for PMR in women in Japan, especially in cases with severe anemia.