PMR Guidelines Spell Out Ultrasound's Role

Initial diagnoses in this group of patients included new-onset RA, connective tissue disease, various shoulder conditions, fibromyalgia, and generalized osteoarthritis, among others, they noted.

"Newer concepts of PMR are revealed by this and other recent studies – heterogeneity at presentation and course, lack of uniform responsiveness to low-dose steroids, and overlap with inflammatory arthritis. However, we feel that at present these classification criteria provide a basic framework for developing clinical trials of novel therapies in PMR," the investigators said, adding that C statistic of 81%, for the algorithm (82% when ultrasound is included), "exceeds the threshold of 80% that is conventionally considered to be useful in clinical decision-making."

"In our view, this approach can now be used to test eligibility for trials with newer therapies in PMR," they said.

The next steps are to validate the classification criteria in another group of patients and to identify better biomarkers for diagnosis and assessment of disease activity and disease damage, Dr. Matteson noted.

The provisional classification criteria are also published simultaneously in the April issue of Annals of the Rheumatic Diseases.

This work was supported by the ACR, EULAR, and the Mayo Foundation, as well as by Biobanque de Picardie in Amiens, France, and by the Ministero de Ciencia y Tecnologia, Spain. Numerous study authors reported various disclosures. Details are included in the full text of the article.