Polymyalgia rheumatica and vertebral fractures: a 1-year pilot controlled study

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• 作者：Luigi Calvo (1)
  Giovanni Pistone (2)
  Sabrina Arnone (3)
  Daniela Colomba (1)
  Salvatore Amico (1)
  Antonella Giacalone (3)
  Pietra Vitale (2)
  Calogero Nicosia (2)
  Eliana Barone (1)
  Rosario Scaglione (1)
  Giuseppe Licata (1)
  Salvatore Corrao (1)
  
• 关键词：Polymyalgia rheumatica ; Vertebral fractures ; Osteoporosis ; Controlled clinical trial
• 刊名：Rheumatology International
• 出版年：2010
• 出版时间：July 2010
• 年：2010
• 卷：30
• 期：9
• 页码：1245-1247
• 全文大小：197KB
• 参考文献：1. Homik J, Suarez-Almazor ME, Shea B, Cranney A, Wells G, Tugwell P (2000) Calcium and vitamin D for corticosteroid-induced osteoporosis. Cochrane Database Syst Rev (2):CD000952
  2. Homik J, Cranney A, Shea B, Tugwell P, Wells G, Adachi R, Suarez-Almazor M (2000) Bisphosphonates for steroid induced osteoporosis. Cochrane Database Syst Rev (2):CD001347
  3. Weyand CM, Goronzy JJ (2001) Polymyalgia rheumatica and giant cell arteritis. In: Koopman WJ (ed) Arthritis and allied conditions—a textbook of rheumatology. pp 1784-798
  4. Pearce G, Ryan PF, Delmas Pd, Tabensky DA, Seeman E (1998) The deleterious effects of low-dose corticosteroids on bone density in patients with polymyalgia rheumatica. British J Rheumatol 37(3):292-99 CrossRef
  5. Chuang TY, Hunder GG, Ilstrup DM, Kurland LT (1982) Polymyalgia rheumatica: a 10-year epidemiologic and clinical study. Ann Intern Med 97:672-80
  6. Healey LA (1984) Long-term follow-up of polymyalgia rheumatica: evidence for synovitis. Semin Arthritis Rheum 13:322-28 CrossRef
  
• 作者单位：Luigi Calvo (1)
  Giovanni Pistone (2)
  Sabrina Arnone (3)
  Daniela Colomba (1)
  Salvatore Amico (1)
  Antonella Giacalone (3)
  Pietra Vitale (2)
  Calogero Nicosia (2)
  Eliana Barone (1)
  Rosario Scaglione (1)
  Giuseppe Licata (1)
  Salvatore Corrao (1)
  
  1. Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy
  2. Outpatient Rheumatologic Clinic, National Relevance Hospital Trust “Civico e Benfratelli, G. Di Cristina, M. Ascoli- Palermo, Italy
  3. Unit of Clinical Methodology, Epidemiology and Statistics, National Relevance Hospital Trust “Civico e Benfratelli, G. Di Cristina, M. Ascoli- Palermo, Italy
  

文摘

No data exist about the possibility that vertebral fracture in PMR patients could be independent of steroid therapy. For this reason, we aimed to investigate this topic by a case cohort study with a 1-year follow-up for each patient. We selected ten consecutive patients who experienced vertebral fractures (VF-group) during the first month of 1-year follow-up period and without any other significant associated condition. As a control group we studied ten control patients, without vertebral fractures and with a follow-up of 1?year, randomly selected among a larger group of patients affected by polymyalgia rheumatica. The following data were analysed: eritrosedimention rate (ESR), visual analogical scale score (VAS), methyprednisolone daily dosage. Each patient had been monthly evaluated by the aforementioned clinical and laboratoristic parameters during the 1-year follow-up period. The VF-group resulted with a higher and statistically significant median corticosteroid 12-month total dosage [mean 3,480?mg (95%CI 2,805-,030) vs. 2,760?mg (2,666.25-,247.5)]. The VF-group had statistically significant higher ESR and VAS AUC when compared to control group (median ESR AUC, 484.75 vs. 288.25; P?=?0.0001; median VAS AUC, 70.75 vs. 43.5 P?<?0.0001); ESR at the baseline (cut-off >80?mm) showed a specificity of 90% (95%CI 56-00) and sensitivity of 70% (95%CI 35-3). VAS difference from first to second month (cut-off ?) showed a specificity of 90% (95%CI 56-00) and sensitivity of 80% (95% CI 44-7). Our results point out that vertebral fracture might be predicted from commonly used laboratory (ESR) and clinical (VAS) findings.