The polymyalgia rheumatica activity score in daily use: proposal for a definition of remission

Arthritis Rheum. 2007 Jun 15;57(5):810-5. doi: 10.1002/art.22771.


Objective: To confirm the reliability and applicability of the Polymyalgia Rheumatica Disease Activity Score (PMR-AS), and to establish a threshold for remission.

Methods: First, 78 patients with PMR (50 women/28 men, mean age 65.97 years) were enrolled in a cross-sectional evaluation. The PMR-AS, patient's satisfaction with disease status (PATSAT; range 1-5), erythrocyte sedimentation rate (ESR; first hour), and a visual analog scale of patients' general health assessment (VAS patient global; range 0-100) were recorded. Subsequently, another 39 PMR patients (24 women/15 men, mean age 68.12 years) were followed longitudinally. Relationships between the PMR-AS, PATSAT, ESR, and VAS patient global were analyzed by the Kruskal-Wallis test, Spearman's rank correlation, and kappa statistics. PMR-AS values in patients with a PATSAT score of 1 and a VAS patient global <10 formed the basis to establish a remission threshold.

Results: PMR-AS values were significantly related to PATSAT (P < 0.001), VAS patient global (P < 0.001), and ESR (P < 0.01). PATSAT and VAS patient global were reasonably different (kappa = 0.226). The median PMR-AS score in patients with PATSAT score 1 and VAS patient global <10 was 0.7 (range 0-3.3), and the respective 75th percentile was 1.3. To enhance applicability, a range from 0 to 1.5 was proposed to define remission in PMR. The median ESR in these patients was 10 mm/hour (range 3-28), indicating external validity.

Conclusion: We demonstrated the reliability, validity, and applicability of the PMR-AS in daily routine. Moreover, we proposed a remission threshold (0-1.5) founded on patient-dependent parameters.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Sedimentation
  • Cross-Sectional Studies
  • Female
  • Glucocorticoids / therapeutic use*
  • Health Status*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data
  • Polymyalgia Rheumatica* / diagnosis
  • Polymyalgia Rheumatica* / drug therapy
  • Polymyalgia Rheumatica* / physiopathology
  • Remission Induction
  • Reproducibility of Results
  • Severity of Illness Index*
  • Treatment Outcome


  • Glucocorticoids