Polymyalgia Rheumatica Not Linked to Increased Mortality

TOPLINE:

In a long-term follow-up study, patients with isolated polymyalgia rheumatica (PMR) and biopsy-confirmed giant cell arteritis (GCA) had no increased all-cause mortality compared with matched individuals; men with PMR showed lower mortality.

METHODOLOGY:

• Researchers assessed long-term all-cause mortality in patients with PMR using data from a prospective, population-based inception cohort in Norway between 1987 and 1997 that was followed for 38 years.
• They included 274 patients with isolated PMR (mean age at diagnosis, 71.9 years; 66.1% women) and 63 patients with GCA (mean age at diagnosis, 71.6 years; 76.2% women), of whom 22 had coexisting PMR and GCA.
• PMR was defined with the fulfilment of criteria suggested by Bird and colleagues, and the diagnosis of GCA was confirmed with a positive temporal artery biopsy.
• Each case of PMR and GCA was matched with 15 individuals from the population registry on the basis of sex, age at inclusion, and residency, resulting in a total of 4110 and 945 individuals, respectively.
• Mortality and survival were assessed using the standard mortality ratio (SMR), with patients being followed up till death or until December 2024.

TAKEAWAY:

• Among all patients with PMR, 96% had died by the end of the study, with a mean follow-up duration of 14 years and a maximum of 35.3 years.
• All-cause mortality in patients with PMR or GCA did not differ significantly from that in matched individuals.
• Men with PMR had significantly lower all-cause mortality (SMR, 0.77; 95% CI, 0.62-0.95); no significant sex-related differences were observed in patients with GCA.
• The overall cumulative survival in patients with PMR or GCA was not significantly different from that in the matched individuals.

IN PRACTICE:

“Our findings align with previous evidence reinforcing that isolated PMR does not sig­nificantly impact survival negatively, offering reassurance to both patients and clinicians regarding its long-term prognosis,” the authors wrote.

SOURCE:

This study was led by Stig Tengesdal, Sørlandet Hospital, Kristiansand, Norway. It was published online on July 21, 2025, in Arthritis Research & Therapy.

LIMITATIONS:

The Bird’s criteria may have relatively poor specificity for PMR. The prevalence of large vessel vasculitis may have been underestimated in the PMR cohort. Cases of malignancy could not be identified and excluded as data from medical charts were limited.

DISCLOSURES:

This study did not receive any specific funding. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.