Cargando…
Longitudinal clusters of pain and stiffness in polymyalgia rheumatica: 2-year results from the PMR Cohort Study
OBJECTIVES: To investigate potential subgroups of primary care–diagnosed patients with PMR based on self-reported pain and stiffness severity over time. METHODS: A total of 652 people with an incident PMR diagnosis were recruited from English general practices and completed a baseline postal questio...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382596/ https://www.ncbi.nlm.nih.gov/pubmed/31742642 http://dx.doi.org/10.1093/rheumatology/kez533 |
_version_ | 1783563276193366016 |
---|---|
author | Muller, Sara Whittle, Rebecca Hider, Samantha L Belcher, John Helliwell, Toby Morton, Chris Hughes, Emily Lawton, Sarah A Mallen, Christian D |
author_facet | Muller, Sara Whittle, Rebecca Hider, Samantha L Belcher, John Helliwell, Toby Morton, Chris Hughes, Emily Lawton, Sarah A Mallen, Christian D |
author_sort | Muller, Sara |
collection | PubMed |
description | OBJECTIVES: To investigate potential subgroups of primary care–diagnosed patients with PMR based on self-reported pain and stiffness severity over time. METHODS: A total of 652 people with an incident PMR diagnosis were recruited from English general practices and completed a baseline postal questionnaire. They were followed up with a further six questionnaires over a 2 year period. A total of 446 people completed the 2 year follow-up. Pain and stiffness were reported on a 0–10 numerical rating scale. Latent class growth analysis was used to estimate the joint trajectories of pain and stiffness over time. A combination of statistical and clinical considerations was used to choose the number of clusters. Characteristics of the classes were described. RESULTS: Five clusters were identified. One cluster represented the profile of ‘classical’ PMR symptoms and one represented sustained symptoms that may not be PMR. The other three clusters displayed a partial recovery, a recovery followed by worsening and a slow, but sustained recovery. Those displaying classical PMR symptoms were in better overall health at diagnosis than the other groups. CONCLUSION: PMR is a heterogeneous condition, with a number of phenotypes. The spectrum of presentation, as well as varying responses to treatment, may be related to underlying health status at diagnosis. Future research should seek to stratify patients at diagnosis to identify those likely to have a poor recovery and in need of an alternative treatment pathway. Clinicians should be aware of the different experiences of patients and monitor symptoms closely, even where there is initial improvement. |
format | Online Article Text |
id | pubmed-7382596 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-73825962020-07-29 Longitudinal clusters of pain and stiffness in polymyalgia rheumatica: 2-year results from the PMR Cohort Study Muller, Sara Whittle, Rebecca Hider, Samantha L Belcher, John Helliwell, Toby Morton, Chris Hughes, Emily Lawton, Sarah A Mallen, Christian D Rheumatology (Oxford) Clinical Science OBJECTIVES: To investigate potential subgroups of primary care–diagnosed patients with PMR based on self-reported pain and stiffness severity over time. METHODS: A total of 652 people with an incident PMR diagnosis were recruited from English general practices and completed a baseline postal questionnaire. They were followed up with a further six questionnaires over a 2 year period. A total of 446 people completed the 2 year follow-up. Pain and stiffness were reported on a 0–10 numerical rating scale. Latent class growth analysis was used to estimate the joint trajectories of pain and stiffness over time. A combination of statistical and clinical considerations was used to choose the number of clusters. Characteristics of the classes were described. RESULTS: Five clusters were identified. One cluster represented the profile of ‘classical’ PMR symptoms and one represented sustained symptoms that may not be PMR. The other three clusters displayed a partial recovery, a recovery followed by worsening and a slow, but sustained recovery. Those displaying classical PMR symptoms were in better overall health at diagnosis than the other groups. CONCLUSION: PMR is a heterogeneous condition, with a number of phenotypes. The spectrum of presentation, as well as varying responses to treatment, may be related to underlying health status at diagnosis. Future research should seek to stratify patients at diagnosis to identify those likely to have a poor recovery and in need of an alternative treatment pathway. Clinicians should be aware of the different experiences of patients and monitor symptoms closely, even where there is initial improvement. Oxford University Press 2020-08 2019-11-19 /pmc/articles/PMC7382596/ /pubmed/31742642 http://dx.doi.org/10.1093/rheumatology/kez533 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Science Muller, Sara Whittle, Rebecca Hider, Samantha L Belcher, John Helliwell, Toby Morton, Chris Hughes, Emily Lawton, Sarah A Mallen, Christian D Longitudinal clusters of pain and stiffness in polymyalgia rheumatica: 2-year results from the PMR Cohort Study |
title | Longitudinal clusters of pain and stiffness in polymyalgia rheumatica: 2-year results from the PMR Cohort Study |
title_full | Longitudinal clusters of pain and stiffness in polymyalgia rheumatica: 2-year results from the PMR Cohort Study |
title_fullStr | Longitudinal clusters of pain and stiffness in polymyalgia rheumatica: 2-year results from the PMR Cohort Study |
title_full_unstemmed | Longitudinal clusters of pain and stiffness in polymyalgia rheumatica: 2-year results from the PMR Cohort Study |
title_short | Longitudinal clusters of pain and stiffness in polymyalgia rheumatica: 2-year results from the PMR Cohort Study |
title_sort | longitudinal clusters of pain and stiffness in polymyalgia rheumatica: 2-year results from the pmr cohort study |
topic | Clinical Science |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382596/ https://www.ncbi.nlm.nih.gov/pubmed/31742642 http://dx.doi.org/10.1093/rheumatology/kez533 |
work_keys_str_mv | AT mullersara longitudinalclustersofpainandstiffnessinpolymyalgiarheumatica2yearresultsfromthepmrcohortstudy AT whittlerebecca longitudinalclustersofpainandstiffnessinpolymyalgiarheumatica2yearresultsfromthepmrcohortstudy AT hidersamanthal longitudinalclustersofpainandstiffnessinpolymyalgiarheumatica2yearresultsfromthepmrcohortstudy AT belcherjohn longitudinalclustersofpainandstiffnessinpolymyalgiarheumatica2yearresultsfromthepmrcohortstudy AT helliwelltoby longitudinalclustersofpainandstiffnessinpolymyalgiarheumatica2yearresultsfromthepmrcohortstudy AT mortonchris longitudinalclustersofpainandstiffnessinpolymyalgiarheumatica2yearresultsfromthepmrcohortstudy AT hughesemily longitudinalclustersofpainandstiffnessinpolymyalgiarheumatica2yearresultsfromthepmrcohortstudy AT lawtonsaraha longitudinalclustersofpainandstiffnessinpolymyalgiarheumatica2yearresultsfromthepmrcohortstudy AT mallenchristiand longitudinalclustersofpainandstiffnessinpolymyalgiarheumatica2yearresultsfromthepmrcohortstudy |