Park Eun Seong, Ahn Sung Soo, Jung Seung Min, Song Jungsik, Park Yong-Beom, Lee Sang-Won
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Int J Rheum Dis. 2018 Oct;21(10):1838-1843. doi: 10.1111/1756-185X.13343. Epub 2018 Aug 30.
To apply 2012 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) criteria to Korean patients previously classified as polymyalgia rheumatica (PMR) by Chuang and Hunder criteria or Healey criteria and investigated whether they might be still reclassified as PMR or not.
We retrospectively reviewed the medical records of 113 previously classified PMR patients. We applied 2012 EULAR/ACR criteria without ultrasonography to PMR patients, and fulfilment required at least 4 points. We evaluated odds ratios (OR) using logistic regression analyses.
The mean age was 61.7 years. Seventy-one patients (62.8%) fulfilled Chuang and Hunder criteria, and 113 patients (100%) met Healey criteria. When we applied 2012 EULAR/ACR criteria, 98 patients fulfilled essential items (≥50 years, bilateral shoulder aching and abnormal C-reactive protein or erythrocyte sedimentation rate), and only 80 patients achieved points ≥4. Eight patients fulfilling the criteria exhibited higher frequencies of all the detailed items than those who did not. In multivariate logistic regression analysis, absence of rheumatoid factor or anti-citrullinated peptide antibodies was the only independent contributing item to the fulfilment of 2012 EULAR/ACR criteria (OR 23.571, 95% CI 6.357-87.407, P < .001). When we reclassified 33 excluded patients, the most common newly classified disease was generalized osteoarthritis (24.2%), followed by osteoporosis with compression fracture (15.2%).
Eighty of 113 patients (81.6%) previously classified by Chuang and Hunder criteria or Healey criteria fulfilled 2012 EULAR/ACR criteria for PMR.
将2012年欧洲抗风湿病联盟/美国风湿病学会（EULAR/ACR）标准应用于先前根据Chuang和Hunder标准或Healey标准分类为风湿性多肌痛（PMR）的韩国患者，并调查他们是否仍可重新分类为PMR。
我们回顾性分析了113例先前分类为PMR患者的病历。我们将不使用超声检查的2012年EULAR/ACR标准应用于PMR患者，满足标准至少需要4分。我们使用逻辑回归分析评估比值比（OR）。
平均年龄为61.7岁。71例患者（62.8%）符合Chuang和Hunder标准，113例患者（100%）符合Healey标准。当我们应用2012年EULAR/ACR标准时，98例患者满足基本项目（≥50岁、双侧肩部疼痛以及C反应蛋白或红细胞沉降率异常），只有80例患者得分≥4分。符合标准的8例患者在所有详细项目上的出现频率均高于不符合标准的患者。在多变量逻辑回归分析中，类风湿因子或抗瓜氨酸化肽抗体阴性是满足2012年EULAR/ACR标准的唯一独立影响因素（OR 23.571，95% CI 6.357 - 87.407，P <.001）。当我们对33例排除的患者进行重新分类时，最常见的新分类疾病是全身性骨关节炎（24.2%），其次是伴有压缩性骨折的骨质疏松症（15.2%）。
113例先前根据Chuang和Hunder标准或Healey标准分类的患者中有80例（81.6%）满足2012年EULAR/ACR标准的PMR。
