Mortality in polymyalgia rheumatica: a 38-year prospective population-based cohort study from Southern Norway

Abstract Background Robust long-term mortality data on patients with polymyalgia rheumatica (PMR) are lacking. The aim of this study was to determine all-cause mortality in isolated PMR using a large, population-based, inception cohort followed prospectively over a 38-year period. Methods Between 19...

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Main Authors: Stig Tengesdal, Øyvind Molberg, Øyvind Holme, Jan Tore Gran, Geirmund Myklebust
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Arthritis Research & Therapy
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Online Access:https://doi.org/10.1186/s13075-025-03613-9
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author Stig Tengesdal
Øyvind Molberg
Øyvind Holme
Jan Tore Gran
Geirmund Myklebust
author_facet Stig Tengesdal
Øyvind Molberg
Øyvind Holme
Jan Tore Gran
Geirmund Myklebust
author_sort Stig Tengesdal
collection DOAJ
description Abstract Background Robust long-term mortality data on patients with polymyalgia rheumatica (PMR) are lacking. The aim of this study was to determine all-cause mortality in isolated PMR using a large, population-based, inception cohort followed prospectively over a 38-year period. Methods Between 1987 and 1997, 337 incident cases of PMR and biopsy-proven GCA were included in a prospective, population-based inception cohort in Aust-Agder County, Norway. Diagnosis was ascertained clinically by a rheumatologist, with PMR cases meeting Bird`s criteria. Patients were followed until death or end of study on December 31st, 2024. Each case was matched by gender, age at inclusion, and residency with 15 population comparators drawn from the population registry in Norway. We assessed mortality and survival by standard mortality ratios (SMR) and the Kaplan-Meier method. Results A total of 274 patients with isolated PMR (66.1% female, mean age at diagnosis 71.9 years) and 63 patients with GCA (76.2% female, mean age at diagnosis 71.6 years) were included. By the end of the study, 96.4% of all patients were deceased. Mean follow-up time for all patients was 13.7 years, with a maximum of 35.3 years. For cases with isolated PMR, the overall SMR was 0.97 (95% confidence interval [CI] 0.85, 1.09), for men 0.77 (95% CI 0.62, 0.95), and for women 1.11 (95% CI 0.95, 1.28). For GCA, the overall SMR was 1.10 (95% CI 0.85, 1.40), with no gender difference. Conclusions In this comprehensive long-term follow-up study with nearly complete data on mortality, isolated PMR was not associated with increased mortality, reinforcing the view that it does not confer a higher mortality risk.
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spelling doaj-art-b7aac32c94fb4ecb8f31d3ac618a9df32025-08-20T03:46:28ZengBMCArthritis Research & Therapy1478-63622025-07-012711910.1186/s13075-025-03613-9Mortality in polymyalgia rheumatica: a 38-year prospective population-based cohort study from Southern NorwayStig Tengesdal0Øyvind Molberg1Øyvind Holme2Jan Tore Gran3Geirmund Myklebust4Department of Research, Sorlandet HospitalInstitute of Clinical Medicine, University of OsloDepartment of Research, Sorlandet HospitalInstitute of Clinical Medicine, University of OsloDepartment of Research, Sorlandet HospitalAbstract Background Robust long-term mortality data on patients with polymyalgia rheumatica (PMR) are lacking. The aim of this study was to determine all-cause mortality in isolated PMR using a large, population-based, inception cohort followed prospectively over a 38-year period. Methods Between 1987 and 1997, 337 incident cases of PMR and biopsy-proven GCA were included in a prospective, population-based inception cohort in Aust-Agder County, Norway. Diagnosis was ascertained clinically by a rheumatologist, with PMR cases meeting Bird`s criteria. Patients were followed until death or end of study on December 31st, 2024. Each case was matched by gender, age at inclusion, and residency with 15 population comparators drawn from the population registry in Norway. We assessed mortality and survival by standard mortality ratios (SMR) and the Kaplan-Meier method. Results A total of 274 patients with isolated PMR (66.1% female, mean age at diagnosis 71.9 years) and 63 patients with GCA (76.2% female, mean age at diagnosis 71.6 years) were included. By the end of the study, 96.4% of all patients were deceased. Mean follow-up time for all patients was 13.7 years, with a maximum of 35.3 years. For cases with isolated PMR, the overall SMR was 0.97 (95% confidence interval [CI] 0.85, 1.09), for men 0.77 (95% CI 0.62, 0.95), and for women 1.11 (95% CI 0.95, 1.28). For GCA, the overall SMR was 1.10 (95% CI 0.85, 1.40), with no gender difference. Conclusions In this comprehensive long-term follow-up study with nearly complete data on mortality, isolated PMR was not associated with increased mortality, reinforcing the view that it does not confer a higher mortality risk.https://doi.org/10.1186/s13075-025-03613-9Polymyalgia rheumaticaGiant cell arteritisEpidemiologyMortalitySurvival
spellingShingle Stig Tengesdal
Øyvind Molberg
Øyvind Holme
Jan Tore Gran
Geirmund Myklebust
Mortality in polymyalgia rheumatica: a 38-year prospective population-based cohort study from Southern Norway
Arthritis Research & Therapy
Polymyalgia rheumatica
Giant cell arteritis
Epidemiology
Mortality
Survival
title Mortality in polymyalgia rheumatica: a 38-year prospective population-based cohort study from Southern Norway
title_full Mortality in polymyalgia rheumatica: a 38-year prospective population-based cohort study from Southern Norway
title_fullStr Mortality in polymyalgia rheumatica: a 38-year prospective population-based cohort study from Southern Norway
title_full_unstemmed Mortality in polymyalgia rheumatica: a 38-year prospective population-based cohort study from Southern Norway
title_short Mortality in polymyalgia rheumatica: a 38-year prospective population-based cohort study from Southern Norway
title_sort mortality in polymyalgia rheumatica a 38 year prospective population based cohort study from southern norway
topic Polymyalgia rheumatica
Giant cell arteritis
Epidemiology
Mortality
Survival
url https://doi.org/10.1186/s13075-025-03613-9
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