An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists

Agnete Overgaard Donskov; Sarah Louise Mackie; Ellen Margrethe Hauge; Carlos Enrique Toro-Gutiérrez; Ib Tønder Hansen; Andrea Katharina Hemmig; Aatke Van der Maas; Tamer Gheita; Berit Dalsgaard Nielsen; Karen M.J. Douglas; Richard Conway; Elena Rezus; Bhaskar Dasgupta; Sara Monti; Eric L. Matteson; Sebastian E. Sattui; Mark Matza; Vanessa Ocampo; Margarita Gromova; Rebecca Grainger; Andrea Bran; Simone Appenzeller; Annelise Goecke; Nelly Colman; Helen I. Keen; Masataka Kuwana; Latika Gupta; Babur Salim; Ghita Harifi; Mariam Erraoui; Nelly Ziade; Nizar Abdulateef Al-Ani; Adeola Ajibade; Johannes Knitza; Line Frølund; Max Yates; Victor R. Pimentel-Quiroz; Andre Marun Lyrio; Maria Sandovici; Kornelis S.M. Van der Geest; Toby Helliwell; Elisabeth Brouwer; Christian Dejaco; Kresten Krarup Keller

doi:10.1093/rheumatology/keac713

An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists

Agnete Overgaard Donskov, Sarah Louise Mackie, Ellen Margrethe Hauge, Carlos Enrique Toro-Gutiérrez, Ib Tønder Hansen, Andrea Katharina Hemmig, Aatke Van der Maas, Tamer Gheita, Berit Dalsgaard Nielsen, Karen M.J. Douglas, Richard Conway, Elena Rezus, Bhaskar Dasgupta, Sara Monti, Eric L. Matteson, Sebastian E. Sattui, Mark Matza, Vanessa Ocampo, Margarita Gromova, Rebecca GraingerAndrea Bran, Simone Appenzeller, Annelise Goecke, Nelly Colman, Helen I. Keen, Masataka Kuwana, Latika Gupta, Babur Salim, Ghita Harifi, Mariam Erraoui, Nelly Ziade, Nizar Abdulateef Al-Ani, Adeola Ajibade, Johannes Knitza, Line Frølund, Max Yates, Victor R. Pimentel-Quiroz, Andre Marun Lyrio, Maria Sandovici, Kornelis S.M. Van der Geest, Toby Helliwell, Elisabeth Brouwer, Christian Dejaco, Kresten Krarup Keller

Internal Medicine

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16 Citations (Web of Science)

Abstract

OBJECTIVES

To explore current management practices for PMR by general practitioners (GPs) and rheumatologists including implications for clinical trial recruitment.

METHODS

An English language questionnaire was constructed by a working group of rheumatologists and GPs from six countries. The questionnaire focused on: 1: Respondent characteristics; 2: Referral practices; 3: Treatment with glucocorticoids; 4: Diagnostics; 5: Comorbidities; and 6: Barriers to research. The questionnaire was distributed to rheumatologists and GPs worldwide via members of the International PMR/Giant Cell Arteritis Study Group.

RESULTS

In total, 394 GPs and 937 rheumatologists responded to the survey. GPs referred a median of 25% of their suspected PMR patients for diagnosis and 50% of these were returned to their GP for management. In general, 39% of rheumatologists evaluated patients with suspected PMR >2 weeks after referral, and a median of 50% of patients had started prednisolone before rheumatologist evaluation. Direct comparison of initial treatment showed that the percentage prescribing >25 mg prednisolone daily for patients was 30% for GPs and 12% for rheumatologists. Diagnostic imaging was rarely used. More than half (56%) of rheumatologists experienced difficulties recruiting people with PMR to clinical trials.

CONCLUSION

This large international survey indicates that a large proportion of people with PMR are not referred for diagnosis, and that the proportion of treatment-naive patients declined with increasing time from referral to assessment. Strategies are needed to change referral and management of people with PMR, to improve clinical practice and facilitate recruitment to clinical trials.

Original language	English
Pages (from-to)	2797-2805
Number of pages	9
Journal	Rheumatology (Oxford, England)
Volume	62
Issue number	8
DOIs	https://doi.org/10.1093/rheumatology/keac713
Publication status	Published - 13 Jan 2023

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Donskov, A. O., Mackie, S. L., Hauge, E. M., Toro-Gutiérrez, C. E., Hansen, I. T., Hemmig, A. K., Van der Maas, A., Gheita, T., Nielsen, B. D., Douglas, K. M. J., Conway, R., Rezus, E., Dasgupta, B., Monti, S., Matteson, E. L., Sattui, S. E., Matza, M., Ocampo, V., Gromova, M., ... Keller, K. K. (2023). An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists. Rheumatology (Oxford, England), 62(8), 2797-2805. https://doi.org/10.1093/rheumatology/keac713

@article{15a21f8d79c74a28828bc458b069d225,

title = "An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists",

abstract = "OBJECTIVES To explore current management practices for PMR by general practitioners (GPs) and rheumatologists including implications for clinical trial recruitment. METHODS An English language questionnaire was constructed by a working group of rheumatologists and GPs from six countries. The questionnaire focused on: 1: Respondent characteristics; 2: Referral practices; 3: Treatment with glucocorticoids; 4: Diagnostics; 5: Comorbidities; and 6: Barriers to research. The questionnaire was distributed to rheumatologists and GPs worldwide via members of the International PMR/Giant Cell Arteritis Study Group.RESULTSIn total, 394 GPs and 937 rheumatologists responded to the survey. GPs referred a median of 25% of their suspected PMR patients for diagnosis and 50% of these were returned to their GP for management. In general, 39% of rheumatologists evaluated patients with suspected PMR >2 weeks after referral, and a median of 50% of patients had started prednisolone before rheumatologist evaluation. Direct comparison of initial treatment showed that the percentage prescribing >25 mg prednisolone daily for patients was 30% for GPs and 12% for rheumatologists. Diagnostic imaging was rarely used. More than half (56%) of rheumatologists experienced difficulties recruiting people with PMR to clinical trials. CONCLUSIONThis large international survey indicates that a large proportion of people with PMR are not referred for diagnosis, and that the proportion of treatment-naive patients declined with increasing time from referral to assessment. Strategies are needed to change referral and management of people with PMR, to improve clinical practice and facilitate recruitment to clinical trials.",

keywords = "diagnostic, glucocorticoid, guideline, PMR, research, treatment",

author = "Donskov, {Agnete Overgaard} and Mackie, {Sarah Louise} and Hauge, {Ellen Margrethe} and Toro-Guti{\'e}rrez, {Carlos Enrique} and Hansen, {Ib T{\o}nder} and Hemmig, {Andrea Katharina} and {Van der Maas}, Aatke and Tamer Gheita and Nielsen, {Berit Dalsgaard} and Douglas, {Karen M.J.} and Richard Conway and Elena Rezus and Bhaskar Dasgupta and Sara Monti and Matteson, {Eric L.} and Sattui, {Sebastian E.} and Mark Matza and Vanessa Ocampo and Margarita Gromova and Rebecca Grainger and Andrea Bran and Simone Appenzeller and Annelise Goecke and Nelly Colman and Keen, {Helen I.} and Masataka Kuwana and Latika Gupta and Babur Salim and Ghita Harifi and Mariam Erraoui and Nelly Ziade and Al-Ani, {Nizar Abdulateef} and Adeola Ajibade and Johannes Knitza and Line Fr{\o}lund and Max Yates and Pimentel-Quiroz, {Victor R.} and Lyrio, {Andre Marun} and Maria Sandovici and {Van der Geest}, {Kornelis S.M.} and Toby Helliwell and Elisabeth Brouwer and Christian Dejaco and Keller, {Kresten Krarup}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].",

year = "2023",

month = jan,

day = "13",

doi = "10.1093/rheumatology/keac713",

language = "English",

volume = "62",

pages = "2797--2805",

journal = "Rheumatology (Oxford, England)",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "8",

}

Donskov, AO, Mackie, SL, Hauge, EM, Toro-Gutiérrez, CE, Hansen, IT, Hemmig, AK, Van der Maas, A, Gheita, T, Nielsen, BD, Douglas, KMJ, Conway, R, Rezus, E, Dasgupta, B, Monti, S, Matteson, EL, Sattui, SE, Matza, M, Ocampo, V, Gromova, M, Grainger, R, Bran, A, Appenzeller, S, Goecke, A, Colman, N, Keen, HI, Kuwana, M, Gupta, L, Salim, B, Harifi, G, Erraoui, M, Ziade, N, Al-Ani, NA, Ajibade, A, Knitza, J, Frølund, L, Yates, M, Pimentel-Quiroz, VR, Lyrio, AM, Sandovici, M, Van der Geest, KSM, Helliwell, T, Brouwer, E, Dejaco, C & Keller, KK 2023, 'An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists', Rheumatology (Oxford, England), vol. 62, no. 8, pp. 2797-2805. https://doi.org/10.1093/rheumatology/keac713

TY - JOUR

T1 - An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists

AU - Donskov, Agnete Overgaard

AU - Mackie, Sarah Louise

AU - Hauge, Ellen Margrethe

AU - Toro-Gutiérrez, Carlos Enrique

AU - Hansen, Ib Tønder

AU - Hemmig, Andrea Katharina

AU - Van der Maas, Aatke

AU - Gheita, Tamer

AU - Nielsen, Berit Dalsgaard

AU - Douglas, Karen M.J.

AU - Conway, Richard

AU - Rezus, Elena

AU - Dasgupta, Bhaskar

AU - Monti, Sara

AU - Matteson, Eric L.

AU - Sattui, Sebastian E.

AU - Matza, Mark

AU - Ocampo, Vanessa

AU - Gromova, Margarita

AU - Grainger, Rebecca

AU - Bran, Andrea

AU - Appenzeller, Simone

AU - Goecke, Annelise

AU - Colman, Nelly

AU - Keen, Helen I.

AU - Kuwana, Masataka

AU - Gupta, Latika

AU - Salim, Babur

AU - Harifi, Ghita

AU - Erraoui, Mariam

AU - Ziade, Nelly

AU - Al-Ani, Nizar Abdulateef

AU - Ajibade, Adeola

AU - Knitza, Johannes

AU - Frølund, Line

AU - Yates, Max

AU - Pimentel-Quiroz, Victor R.

AU - Lyrio, Andre Marun

AU - Sandovici, Maria

AU - Van der Geest, Kornelis S.M.

AU - Helliwell, Toby

AU - Brouwer, Elisabeth

AU - Dejaco, Christian

AU - Keller, Kresten Krarup

N1 - Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].

PY - 2023/1/13

Y1 - 2023/1/13

N2 - OBJECTIVES To explore current management practices for PMR by general practitioners (GPs) and rheumatologists including implications for clinical trial recruitment. METHODS An English language questionnaire was constructed by a working group of rheumatologists and GPs from six countries. The questionnaire focused on: 1: Respondent characteristics; 2: Referral practices; 3: Treatment with glucocorticoids; 4: Diagnostics; 5: Comorbidities; and 6: Barriers to research. The questionnaire was distributed to rheumatologists and GPs worldwide via members of the International PMR/Giant Cell Arteritis Study Group.RESULTSIn total, 394 GPs and 937 rheumatologists responded to the survey. GPs referred a median of 25% of their suspected PMR patients for diagnosis and 50% of these were returned to their GP for management. In general, 39% of rheumatologists evaluated patients with suspected PMR >2 weeks after referral, and a median of 50% of patients had started prednisolone before rheumatologist evaluation. Direct comparison of initial treatment showed that the percentage prescribing >25 mg prednisolone daily for patients was 30% for GPs and 12% for rheumatologists. Diagnostic imaging was rarely used. More than half (56%) of rheumatologists experienced difficulties recruiting people with PMR to clinical trials. CONCLUSIONThis large international survey indicates that a large proportion of people with PMR are not referred for diagnosis, and that the proportion of treatment-naive patients declined with increasing time from referral to assessment. Strategies are needed to change referral and management of people with PMR, to improve clinical practice and facilitate recruitment to clinical trials.

AB - OBJECTIVES To explore current management practices for PMR by general practitioners (GPs) and rheumatologists including implications for clinical trial recruitment. METHODS An English language questionnaire was constructed by a working group of rheumatologists and GPs from six countries. The questionnaire focused on: 1: Respondent characteristics; 2: Referral practices; 3: Treatment with glucocorticoids; 4: Diagnostics; 5: Comorbidities; and 6: Barriers to research. The questionnaire was distributed to rheumatologists and GPs worldwide via members of the International PMR/Giant Cell Arteritis Study Group.RESULTSIn total, 394 GPs and 937 rheumatologists responded to the survey. GPs referred a median of 25% of their suspected PMR patients for diagnosis and 50% of these were returned to their GP for management. In general, 39% of rheumatologists evaluated patients with suspected PMR >2 weeks after referral, and a median of 50% of patients had started prednisolone before rheumatologist evaluation. Direct comparison of initial treatment showed that the percentage prescribing >25 mg prednisolone daily for patients was 30% for GPs and 12% for rheumatologists. Diagnostic imaging was rarely used. More than half (56%) of rheumatologists experienced difficulties recruiting people with PMR to clinical trials. CONCLUSIONThis large international survey indicates that a large proportion of people with PMR are not referred for diagnosis, and that the proportion of treatment-naive patients declined with increasing time from referral to assessment. Strategies are needed to change referral and management of people with PMR, to improve clinical practice and facilitate recruitment to clinical trials.

KW - diagnostic

KW - glucocorticoid

KW - guideline

KW - PMR

KW - research

KW - treatment

UR - http://www.scopus.com/inward/record.url?scp=85164388519&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/keac713

DO - 10.1093/rheumatology/keac713

M3 - Article

C2 - 36637182

AN - SCOPUS:85164388519

SN - 1462-0324

VL - 62

SP - 2797

EP - 2805

JO - Rheumatology (Oxford, England)

JF - Rheumatology (Oxford, England)

IS - 8

ER -

An international survey of current management practices for polymyalgia rheumatica by general practitioners and rheumatologists

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