AB1109 THE TIME-TO-EVENT ANALYSIS OF THE APPLICATION OF ULTRASOUND TO DISTINGUISHING PMR
Background:Japan is the world’s most aged country. The number of patients with polymyalgia rheumatic (PMR) is expected to increase more.Classification criteria including ultrasound findings were published in 2012(1), but the ability to differentiate PMR from other mimicking diseases was unknown.It is difficult to diagnose PMR accurately. We will clarify whether recently reported ultrasound findings (2, 3) which could be characteristic in PMR are helpful for distinguishing from other mimicking diseases and treatment outcome in suspected PMR patients. Neither diagnostic laboratory test nor specific antibody exist, and inflammatory markers such as C reactive protein and erythrocyte sedimentation rate are not specific.Objectives:Patients who were clinically suspected of PMR and underwent ultrasound examination from 2008 to 2018. And Patients who visited the hospital with PMR and were diagnosed with PMR from 2008 to 2018.Methods:Patients who visited the hospital and were diagnosed with PMR were extracted from the medical record database of the hospital. Patients who had been administrated GC at the first visit and whose records were not confirmed were excluded. Patients who were clinically diagnosed with PMR without ultrasound(Cli-PMR), patients who were diagnosed with PMR with ultrasound reports(US-Cli-PMR), patients who were diagnosed by the ultrasound expert only based on ultrasound images(US-PMR).Patient were followed up for one year. Clinical diagnoses were confirmed at the 6 months and 12 months since the first GC administration.Three groups were compared with each other in the rate of diagnosis change and the time intervals between the initiation of GC treatment and the occurrence of events: recurrence, methotrexate introduction and the normalization of C reactive protein.the Kaplan–Meier method was used to evaluate the outcomes. Statistical analyses were conducted with R software, version 3.5.2 (R Foundation for Statistical Computing) and EZR(4).Results:545 PMR patients were extracted. 403 of 545 was excluded because of preexisting GC therapy and record availability.At the 6 months follow-up, 92.8% of the non-US PMR group and 97% of US-PMR group remain PMR and at the 12 months follow-up 88.8% and 95% respectively. There was no significant difference in the three time-to-event outcomes.Conclusion:Ultrasound did not contribute the improvement of the PMR outcomes. However, this finding was affected by confounding factors for example assignment to ultrasound and atypical cases and rheumatologists’ uncertainness. Despite confounding factors, US-PMR group was not inferior. These findings showed that ultrasound may be useful for the complicated cases.References:[1]ARTHRITIS & RHEUMATISMVol. 64, No. 4, April 2012, pp 943–954[2]Clin Med Insights Arthritis Musculoskelet Disord 2017;10: 1179544117745851.[3]Biomed Res Int 2017;2017: 4272560.[4]Bone Marrow Transplantation 2013: 48, 452–458Disclosure of Interests:None declared