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.