Mortality among Patients with Polymyalgia Rheumatica: A Retrospective Cohort Study.

Objective To determine whether a diagnosis of polymyalgia rheumatica (PMR) is associated with premature mortality. Methods We extracted anonymized electronic medical records of patients ages >40 years who were eligible for linkage with the Office for National Statistics Death Registration data set, from the Clinical Practice Research Datalink from 1990 to 2016. Patients with PMR were individually matched, by age, sex, and registered general practice, with up to 5 controls without PMR. The total number and proportion of deaths and mortality rates were calculated. The mortality rate ratio (MRR) with 95% confidence interval (95% CI), adjusted for age, sex, region, smoking status, body mass index, and alcohol consumption, was calculated using Poisson regression. The 20 most common causes of death were tabulated. Results A total of 18,943 patients with PMR were matched to 87,801 controls. The mean +/- SD follow-up after date of diagnosis was 8.0 +/- 4.4 years in patients with PMR and 7.9 +/- 4.6 years in controls. PMR was not associated with an increase in the risk of death (adjusted MRR 1.00 [95% CI 0.97-1.03]) compared to matched controls. Causes of death were broadly similar between patients with PMR and controls, although patients with PMR were slightly more likely to have a vascular cause of death recorded (24% versus 23%). Conclusion A diagnosis of PMR does not appear to increase the risk of premature death. Minor variations in causes of death were observed, but overall this study is reassuring for patients with PMR and for clinicians.