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Study: New EULAR/ACR Classification Criteria Inadequate to Differentiate Polymyalgia Rheumatica From Mimicking Conditions
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Although investigators found 2012 European League Against Rheumatism/American College of Rheumatology clinical criteria for classification of polymyalgia rheumatica were highly sensitive, they noted the measure was inadequate in telling the condition from other inflammatory or non-inflammatory shoulder conditions.
Researchers conducted a prospective multicenter study of 275 patients older than 50 years with new-onset bilateral shoulder pain with acute-phase reactants. Patients were followed for 52 weeks. Investigators used the 2010 and 2012 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) clinical criteria to assess the patients for polymyalgia rheumatica (PMR).
Investigators found 133 patients were diagnosed with PMR and 143 patients had non-PMR conditions, such as rheumatoid arthritis (RA). Investigators also estimated the discriminating capacity, sensitivity and specificity of both criteria sets. The capacity was determined with calculations of receiver-operating characteristics with areas under the curve (AUC).
Results showed good discriminating capacity of new clinical EULAR/ACR clinical criteria for patients with PMR vs. patients without PMR and RA, with an AUC of 0.736 and 0.781, respectively. The sensitivity of the new criteria was 89.5% and the sensitivity was 57.7% against non-PMR patients. Investigators noted when new criteria were tested against all RA patients, seropositive RA patients, seronegative RA patients and control patients without RA, the specificity was reported as 66.75, 100%, 20.7% and 49.3%, respectively.
According to researchers, except for the Bird criteria, there were four 2010 EULAR/ACR criteria with lower sensitivity and higher specificity compared with new EULAR/ACR clinical criteria for distinguishing PMR from controls. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.
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