POS0955 CHARACTERIZATION OF PATIENTS WITH POLYMYALGIA RHEUMATICA IN THE ARTESER GIANT CELL ARTERITIS REGISTRY

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Background: Giant cell arteritis (GCA) is a chronic granulomatous vasculitis affecting medium- and large-sized arteries [1]. The classic symptoms are cranial symptoms, including headache, jaw claudication, scalp hyperalgesia and sometimes visual disturbances. Additionally, extracranial involvement may occur due to stenosis and aneurysms in different segments of the aorta, potentially leading to pulse loss and limb claudication. Polymyalgia rheumatica (PMR) is a disease characterized by pain and stiffness in the cervical region and/or the shoulder and/or pelvic girdles [2]. Approximately, 50% of patients with GCA also present with PMR [3]. Objectives: The aim of this study was to define the clinical, analytical and imaging characteristics, as well as the factors associated with PMR in patients with GCA. Methods: The ARTESER study (Arteritis of the Spanish Society of Rheumatology), promoted by the Spanish Society of Rheumatology, is a longitudinal observational study based on a review of clinical records of patients diagnosed with GCA between June 1, 2013, and March 29, 2019, in 26 hospitals of the Spanish National Health System. Sociodemographic, clinical, analytical, and imaging variables at diagnosis were collected. Additionally, treatment and outcome variables were recorded at the end of follow-up. Patients with and without PMR were compared through a bivariate analysis. To identify potential factors associated with PMR, a multivariate logistic regression model was performed. Statistical significance set at p<0.05. Results: A total of 1,527 patients with GCA were included in the analysis, of whom 43.6% presented with PMR at the time of diagnosis (Table 1). When comparing patients with and without PMR at diagnosis, it was observed that patients with PMR had a higher proportion of women, were younger, and had a longer duration of symptoms (p<0.05). Regarding comorbidities, patients with PMR showed lower rates of smoking and a higher frequency of osteoporosis. They also more frequently presented scalp hypersensitivity, jaw claudication, and constitutional syndrome (p<0.05). Regarding treatment, the initial dose of corticosteroids at diagnosis was lower in patients with PMR (p<0.001). When evaluating outcomes, patients with PMR experienced more relapses, with minor relapses being particularly more frequent in this group (p=0.024). In the multivariate analysis, factors associated with PMR were longer symptom duration at diagnosis, the presence of jaw claudication, asthenia, and synovitis. Conversely, the initial dose of glucocorticoids was associated with a lower risk of PMR (Table 2). Conclusion: Patients with GCA and PMR present a longer duration of symptoms at diagnosis, higher prevalence of osteoporosis, scalp hypersensitivity, jaw claudication, constitutional syndrome, cranial phenotype and a lower initial corticosteroid dose. Factors associated with PMR included longer symptom duration, jaw claudication, asthenia and synovitis, while the initial corticosteroid dose was associated with a lower risk of PMR. REFERENCES: [1] Koster MJ, Matteson EL, Warrington KJ. Large-vessel giant cell arteritis: diagnosis, monitoring and management. Rheumatology (Oxford) 2018;57(suppl_2):ii32-42. [2] Buttgereit F, Dejaco C, Matteson EL, Dasgupta B. Polymyalgia Rheumatica and Giant Cell Arteritis: A Systematic Review JAMA 2016;315(22):2442. [3] Weyand CM, Goronzy JJ. Giant-Cell Arteritis and Polymyalgia Rheumatica. Solomon CG, editor. N Engl J Med. 2014;371(1):50-7. Table 1Demographic characteristics, clinical variables and phenotypes of patients with GCA according to presence of PMR.Total (n=1527)Non-PMR (n=861)PMR (n=666)p-valueWomen, n (%)1076 (70,46)580 (67.36)496 (74.47)0.003Age, mean (SD)76.95 (8.05)77.35 (8.03)76.45 (8.06)0.030Duration of symptoms (months), median (IQR)15.74 (6.69 - 35.41)12.20 (5.11 - 25.97)24 (11.41 - 48)<0.001Smoker, n (%)116 (8.04)81 (9.98)35 (5.55)0.005Headache, n (%)1215 (79.72)672 (78.14)543 (81.78)0.080Temporal artery abnormalities, n (%)744 (52.39)417 (51.04)327 (54.23)0.234Scalp hypersensitivity, n (%)412 (30.68)216 (28.16)196 (34.03)0.021Mandibular claudication, n (%)549 (37.27)281 (33.65)268 (42.01)0.001Visual manifestations, n (%)541 (35.9)362 (42.24)179 (27.54)<0.001Stroke, n (%)57 (3.83)39 (4.62)18 (2.80)0.070Synovitis, n (%)82 (5.99)15 (1.95)67 (11.19)<0.001Constitutional syndrome, n (%) (n=1393)928 (60.77)470 (54.59)458 (68.77)<0.001Asthenia, n (%)795 (56.14)382 (47.10)413 (68.26)<0.001Anorexia, n (%)559 (40.13)284 (35.32)275 (46.69)<0.001Weight loss, n (%)497 (36.01)254 (31.83)243 (41.75)<0.001Fever, n (%)330 (23.72)187 (22.94)143 (24.83)0.416Cranial phenotype, n (%)412 (26.98)209 (24.27)203 (30.48)0.007Involvement of large vessels phenotype, n (%)99 (6.48)57 (6.62)42 (6.31)0.805Mixed phenotype, n (%)201 (13.16)119 (13.82)82 (12.31)0.387 Table 2Multivariate analysis.OR95% CIp-valueSex0.9860.768 - 1.2650.910Age0.9950.983 - 1.0080.478Duration of symptoms1.0021.001 - 1.0030.002Ex-smoker1.1720.740 - 1.8580.498Never smoker1.3460.882 - 2.0550.169Scalp hypersensitivity1.0420.843 - 1.2880.702Mandibular claudication1.3491.054 - 1.7260.017Vision manifestations0.9000.688 - 1.1790.445Synovitis1.6561.187 - 2.3110.003Constitutional syndrome1.1260.727 - 1.7460.595Asthenia1.5331.022 - 2.2980.039Anorexia0.9490.717 - 1.2560.717Weight loss0.8980.682 - 1.1830.445Cranial1.2980.990 - 1.7010.059Prednisone dose at diagnosis0.6600.447 - 0.9750.037Methotrexate0.9360.725 - 1.2090.614Leflunomide0.7680.102 - 5.7690.797Tocilizumab0.8110.480 - 1.3700.434Relapses1.0920.953 - 1.2510.204 Acknowledgements: NIL . Disclosure of Interests: None declared . © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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