Work

Frequency, diagnosis, and management of polymyalgia rheumatica in Germany—database analysis of medical insurance data

Year: 2025

Type: article

Abstract: OBJECTIVES: Epidemiological data on polymyalgia rheumatica (PMR) in Germany is limited. Current national prevalence estimates are low by international standards. This study aimed to gain up-to-date data representative of Germany. METHODS: A cross-sectional analysis was conducted on a sample of 4.8 million insured individuals, representative of the German population, from the InGef (Institute for Health Research Berlin GmbH) research database. Inclusion criteria were age ≥50 years, continuous insurance status for a base period of 3 years and for the subsequent 2 years for longitudinal analysis. Results were additionally extrapolated to the German population. RESULTS: Each year from 2018 to 2021, around 1.7 million insured individuals were included in the study. Extrapolated to the German population in 2021, the incidence was 111/100 000 and the prevalence was 937/100 000. Diagnosis was made predominantly in outpatient settings (86.7%) most frequently by general practitioners (GP; 37.1%), internists (22.2%), rheumatologists (11.4%) and orthopaedists (10.2%). An additional 21% were referred to rheumatologists for treatment after diagnosis. Treatment was most commonly initiated by GPs, followed by rheumatologists, and included methotrexate in 19.8%. Most common comorbidities of prevalent patients comprised arterial hypertension (75.9%), dyslipidaemia (55.0%), diabetes mellitus (29.7%), osteoporosis (27.1%), coronary heart disease (23.4%) and cataract (24.3%). CONCLUSION: This analysis revealed that PMR occurs more frequently in individuals aged 50 or older in Germany than previously assumed. Diagnosis is primarily made in general practice settings, with about one-third of patients being treated by rheumatologists. Comorbidities such as diabetes mellitus or cardiovascular diseases are common in the prevalent population.

Source: Lara D. Veeken

DOI: 10.1093/rheumatology/keaf367