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

Research output: Contribution to journalArticlepeer-review


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 languageEnglish
Pages (from-to)2797-2805
Number of pages9
JournalRheumatology (Oxford, England)
Issue number8
Early online date13 Jan 2023
Publication statusPublished - 1 Aug 2023


  • Humans
  • Giant Cell Arteritis/diagnosis
  • Polymyalgia Rheumatica/diagnosis
  • General Practitioners
  • Rheumatologists
  • Glucocorticoids/therapeutic use
  • Prednisolone/therapeutic use
  • Surveys and Questionnaires


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