Definitions of and instruments for disease activity, remission, and relapse in polymyalgia rheumatica: A systematic literature review

Bolhuis, Thomas E., Bosch, Philipp, Falzon, Louise, Owen, Claire E., Yates, Max ORCID: https://orcid.org/0000-0003-3977-8920, Mackie, Sarah L., van der Maas, Aatke and Dejaco, Christian (2024) Definitions of and instruments for disease activity, remission, and relapse in polymyalgia rheumatica: A systematic literature review. Rheumatology. ISSN 1462-0324

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Abstract

OBJECTIVE: To perform a systematic literature review on definitions and instruments used to measure remission, relapse, and disease activity in polymyalgia rheumatica (PMR), to inform an OMERACT project to endorse instruments for these outcomes. METHODS: A search of Pubmed/MEDLINE, EMBASE, CINAHL, Cochrane, and Epistemonikos was performed May 2021 and updated August 2023. Qualitative and quantitative studies published in English were included if they recruited people with isolated PMR regardless of treatment. Study selection and data extraction was performed independently by two investigators and disagreement was resolved through discussion. Data extracted encompassed definitions of disease activity, remission and relapse, and details regarding the instruments used to measure these outcomes. RESULTS: From the 5,718 records, we included 26 articles on disease activity, 36 on remission, and 53 on relapse; 64 studies were observational and 15interventional, and none used qualitative methods. Some heterogeneity was found regarding definitions and instruments encompassing the domains pain, stiffness, fatigue, laboratory markers (mainly acute phase reactants), and patient and physician global assessment of disease activity. However, instruments for clinical signs were often poorly described. Whilst measurement properties of the polymyalgia rheumatica activity score (PMR-AS) have been assessed, data to support its use for measurement of remission and relapse is limited. CONCLUSION: Remission, relapse, and disease activity have been defined heterogeneously in clinical studies. Instruments to measure these disease states still need to be validated. Qualitative research is needed to better understand the concepts of remission and relapse in PMR.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Population Health Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Depositing User:	LivePure Connector
Date Deposited:	27 Aug 2024 15:30
Last Modified:	25 Sep 2024 18:04
URI:	https://ueaeprints.uea.ac.uk/id/eprint/96361
DOI:	10.1093/rheumatology/keae428

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