Analysis of Related Factors Influencing One-year Recurrence of Polymyalgia Rheumatica

Objective To identify factors associated with the recurrence of polymyalgia rheumatica (PMR) within one year. Methods This study included 64 patients diagnosed with PMR at Peking Union Medical College Hospital between January 2019 and June 2024. The baseline characteristics of patients with and without recurrence were compared, and logistic regression analysis was performed to identify risk factors for recurrence. Results The mean age at onset was 65.1 ± 7.9 years, with a male-to-female ratio of 1:3.3. The average duration from onset to diagnosis was 4.5 ± 3.7 months. At baseline, the average erythrocyte sedimentation rate (ESR) was 67.0 ± 29.2 mm/h, with 11 patients (17.2%) having an ESR >100 mm/h, and the average C-reactive protein (CRP) level was 57.9 ± 51.3 mg/L. Corticosteroids were used as the initial treatment in 95.3% of patients, with an average dose of 21.6 ± 11.6 mg/day. During the 12- month follow-up, 35.9% of patients experienced recurrence, with the median time to first recurrence being 8.2 ± 3.3 months. The cumulative recurrence rates at 3, 6, 9, and 12 months were 6.3%, 14.1%, 25%, and 35.9%, respectively. Comparisons between patients with and without recurrence revealed significant differences in age (68.7 ± 6.5 vs. 63.2 ± 8.1 years, P=0.006) and serum albumin (ALB) levels (36.8 ± 4.2 vs. 39.4 ± 5.0 g/L, P=0.046). Multivariate logistic regression analysis identified age as a significant predictor of recurrence (OR=1.094, 95% CI:1.001-1.196, P=0.033), with each additional year of age increasing the risk of recurrence by 9.4%, suggesting that age may serve as an independent risk factor for recurrence. Conclusion The one-year recurrence rate of PMR is 35.9%. Older age and lower serum albumin levels are associated with recurrence, and age may be associated with disease recurrence within one year.