PMR cohort study

A cohort study of patients diagnosed with polymyalgia rheumatica (PMR) within primary care to research how PMR is currently being managed within primary care, and what happens to these patients during the follow-up time.  

Study Name: PMR (Polymyalgia Rheumatica): A cohort study
Chief Investigator: Prof Christian Mallen / Dr Sara Muller
Study Co-ordinator: To be confirmed
Funder Name/Reference Number: Arthritis Research UK Clinician Scientist Award 2011-2014/Arthritis Research UK (grant number 21827)
UKCN Study Portfolio:  CPMS 12752
Year:       2012-2016, 2018-2021

Study Design

A cohort study of patients diagnosed with polymyalgia rheumatica (PMR) in primary care. The study identifies patterns of symptoms and other events in primary care that precede a diagnosis of PMR and describes what happens to patients with this condition. 

Originally funded to follow people over 2 years, we will now contact people again up to 6 years after their PMR diagnosis. PParticipants will be contacted in early 2019 with a follow-up questionnaire.

Primary Objective

The PMR study is an on-going project to study the course of polymyalgia rheumatica (PMR) from its initial diagnosis in primary care. It covers aspects of the conditions, such as pain, stiffness, activities of daily living, common mental health problems (anxiety and depression), sleep and fatigue, sociodemographics and PMR treatments. These data will be used to look at how PMR is currently managed in primary care and what happens to patients during the follow-up time. 

We have recruited people from across the country who have completed questionnaires and the majority have allowed us to access their medical records. From this, we hope to gain a better understanding of the course of the PMR over time, as well as its outcomes. Unlike previous studies into PMR, this is based entirely in primary care, where around 80% of patients receive all their care for this condition, aiming to provide evidence to improve the way GPs diagnose and manage PMR. 

The newly funded follow-up to this study will specifically look at who is likely to be treated for longer than the 2 years normally expected, who might develop side-effects from treatment, and how PMR affects people's quality of life in the long term. 

Publications

We have already started to publish work from this on-going study and have lots more in the pipeline. 

This paper describes the study in more detail; 

Muller S, Hider S, Helliwell T, Bailey J, Barraclough K, Cope L, Dasgupta B, Foskett R, Hughes R, Mayson Z, Purcell C, Roddy E, Wathall S, Zwierska I, Mallen CD. The epidemiology of polymyalgia rheumatica in primary care: a research protocol. BMC Musculoskelet Disord. 2012 Jun 15;13:102

Our first findings from the study won a prize from the Royal College of General Practitioners. Research Paper of the Year (Category 6: Endocrinology (incl. Diabetes), Gastroenterology, Musculoskeletal and Trauma, and Dermatology): 

Muller S, Hider SL, Helliwell T, Lawton S, Barraclough K, Dasgupta B, Zwierska I, Mallen CD. Characterising those with incident polymyalgia rheumatica in primary care: results from the PMR Cohort Study. Arthritis Res Ther. 2016 Sep 7;18:200.

This paper describes what patients think caused their PMR: 

Tshimologo M, Saunders B, Muller S, Mallen CD, Hider SL. Patients' views on the causes of their polymyalgia rheumatica: a content analysis of data from the PMR Cohort Study. BMJ Open. 2017;7(1):e014301.

This paper describes symptoms reported by PMR that could be related to another condition called giant cell arteritis:
Masson W, Muller S, Whittle R, Helliwell T, Mallen C, Hider S. Possible giant cell arteritis symptoms are common in newly diagnosed patients with Polymyalgia Rheumatica: results from an incident primary care PMR cohort. BMC Rheumatology 2017;1:7