Rheumatology internationalNov 11, 2017

Long-term steroid treatment in patients with muscle inflammation, blood vessel inflammation, or both: results from a national rheumatology database

Longevity & Aging Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 2, 2026

Abstract

A total of 76% of patients with polymyalgia rheumatica (PMR) or giant cell arteritis (GCA) received glucocorticoids (GCs).

Among patients with PMR, GCA, or both, 19% received methotrexate for PMR and 40% for GCA.
Median GC doses were 12.5 mg for PMR, 11.3 mg for GCA, and 20.0 mg/day for PMR + GCA within the first 0-6 months of disease duration.
Patients with PMR reached median GC doses of ≤ 5 mg/day at an estimated 13-18 months of disease duration, while GCA and PMR + GCA patients did so at 19-24 months.
Predictors for GC use for 3 years or more included baseline methotrexate, higher GC doses, increased disease activity, and female sex.
Osteoporosis prevalence was the only comorbidity to increase over 3 years among patients.

Simplified

The objective of this study was to evaluate glucocorticoid (GC) use in patients with polymyalgia rheumatica (PMR), giant cell arteritis (GCA) or both diseases (PMR + GCA) under rheumatological care. Data from patients with PMR (n = 1420), GCA (n = 177) or PMR + GCA (n = 261) from the National Database of the German Collaborative Arthritis Centers were analyzed regarding GCs and related comorbidities (osteoporosis, diabetes and cardiovascular disease), stratified by disease duration (DD). Longitudinal data were analyzed for all patients with a DD ≤ 2 years at database entry (n = 1397). Three-year data were available for 256 patients. Predictors of GC use ≥ 3 years were examined by logistic regression analyses. A total of 76% received GCs, and 19% (PMR) to 40% (GCA) received methotrexate. Median GC doses were 12.5 mg (PMR), 11.3 mg (GCA), and 20.0 mg/day (PMR + GCA) in a 0-6-month DD. Median GC doses ≤ 5 mg/day were reached at a 13-18-month DD in PMR patients and at a 19-24-month DD in GCA or PMR + GCA patients. In the multivariate analysis, baseline methotrexate (OR 2.03, [95% CI 1.27-3.24]), GCs > 10 mg/day (OR 1.65, [1.07-2.55]), higher disease activity (OR 1.12, [1.02-1.23]) (median 0.6 years DD), and female sex (OR 1.63 [1.09-2.43]) were predictive for GC therapy at ≥ 3 years. Of the examined comorbidities, only osteoporosis prevalence increased within 3 years. GC use for ≥ 3 years was reported in one-fourth of all the patients. A difficult-to-control disease activity within the first year was a good predictor of long-term GC need.

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Long-term steroid treatment in patients with muscle inflammation, blood vessel inflammation, or both: results from a national rheumatology database

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