Polymyalgia Rheumatica (PMR) Score – Using It for Steroid Dose

Had a complaint that Doctors leave patient’s in agony  with PMR without thought of their needed prednisone dose – here’s how to figure needed dose out by calculating their disease activity.

J Rheumatol. 2012 Feb;39(2):310-3.
Contribution of the polymyalgia rheumatica activity score to glucocorticoid dosage adjustment in everyday practice.
Cleuziou C, Binard A, De Bandt M, Berthelot JM, Saraux A.  abstract here

Test as follows:

Serum CRP mg/dl  __________
Minutes morning stiffness X0.1 = _____________
Physician’s global assessement (0-10)
No activity|0–1–2–3–4–5–6–7–8–9–10|Extreme activity
Patient view of Pain Level (0-10)
No pain|0–1–2–3–4–5–6–7–8–9–10|Extreme Pain
Ability to raise arm:
over 90 degrees = 0
90 degrees = 1
Less than 90 = 2
None = 3

Scores often range from 0-50

<5 – reduce prednisone
5-10 – reduce or keep same
10-20 – reduce, same or increase Prednisone
Over 20 – increase Prednisone >5 mg though rarely keep same

Word document for use PMR_AS

For a patient this means:

If Pain is 7/10 = 7

Can’t raise arm to shoulder level = 3

Stiff in AM for an hour  = 60 X 0.1  = 6

This would give a score or 16 without even knowing serum CRP or Physician’s rating – enough by self to consider increasing prednisone.

For suffering patient – take in this scale and show your physician; For Doctor’s – here’s a guide – though I would be inclined to add methotrexate to increase control as well.

Any thoughts?

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