Articles By Sarah Mackie, MRCP, PhD
Best of 2023: PMR: glad or bad tidings?
Please don’t tell your patient that PMR “typically” lasts two years. According to real-world data from the UK, one in four patients with PMR is prescribed steroids by their primary care physician for over four years. But nobody tells them this at the start, and that causes big problems later on.
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Blinkers and the Unseen Information Gap in PMR
In my earlier blog, PMR: glad or bad tidings? I mentioned our PMR Voices 2021 public engagement project. This project brought home to me as a physician that although our expertise is essential, one unfortunate side-effect is that our very expertise can give us “blinkers”. One result of our “blinkers” is that we may fail to see the extent of the information gap between us and our patients with newly-diagnosed PMR.
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When PMR Strikes Young, It Hits Hard
Narratives around polymyalgia rheumatica (PMR) often centre around “older people” or even “elderly”. And, indeed, the peak of the age distribution is in the mid-70s – not that everyone that age considers themselves old. Treating “young PMR” can be a very different proposition to treating someone in their seventies or eighties. It’s worth taking time to think this through.
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What Causes PMR?
What causes polymyalgia rheumatica? It could be said that PMR occurs when trajectories of aging take a wrong turn, but it’s still not clear exactly what it is that causes this to happen. The ideas that follow will doubtless seem, to immunologists, vague and oversimplified; but even a partial picture might still offer a possible framework for clinicians and patients for thinking about treatment and care.
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PMR: glad or bad tidings?
Please don’t tell your patient that PMR “typically” lasts two years. According to real-world data from the UK, one in four patients with PMR is prescribed steroids by their primary care physician for over four years. But nobody tells them this at the start, and that causes big problems later on.
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