Epidemiology of Polymyalgia Rheumatica in Korea

In Young Kim; Gi Hyeon Seo; Seulkee Lee; Hyemin Jeong; Hyungjin Kim; Jaejoon Lee; Eun-Mi Koh; Hoon-Suk Cha

doi:10.4078/jrd.2014.21.6.297

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Kim, Seo, Lee, Jeong, Kim, Lee, Koh, and Cha: Epidemiology of Polymyalgia Rheumatica in Korea

Original Article

J Rheum Dis 2014;21(6):297-302.

Published online: 31 October 2014

DOI: https://doi.org/10.4078/jrd.2014.21.6.297

Epidemiology of Polymyalgia Rheumatica in Korea

In Young Kim^1,^*, Gi Hyeon Seo^2,^*, Seulkee Lee¹, Hyemin Jeong¹, Hyungjin Kim¹, Jaejoon Lee¹, Eun-Mi Koh¹, Hoon-Suk Cha¹

¹Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

²Health Insurance Review and Assessment Service, Seoul, Korea

Corresponding to: Hoon-Suk Cha, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. E-mail: hoonsuk.cha@samsung.com *The first two authors contributed equally to this work.

^* The first two authors contributed equally to this work.

Received 26 August 2014 Revised 29 September 2014 Accepted 30 September 2014

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

Polymyalgia rheumatica is a chronic inflammatory disease that affects people older than 50 years of age. The diagnosis is made based on clinical features, and the current standard of treatment is low-dose glucocorticoids. PMR is more commonly reported in Caucasians and females. However, epidemiological studies of PMR in Asian countries are scarce. We aimed to estimate the epidemiology of PMR in Korea.

Methods

This study was conducted by analyzing the Health Insurance Review and Assessment databases. We verified all claims between 2007 and 2012. Cases were included when PMR ICD-10 code (M 35.3) was recorded more than twice, and glucocorticoids were prescribed for ≥30 days.

Results

We identified 1,463 newly diagnosed cases of PMR during the 5 years. Among them, 992 (67.8%) were female, and the mean age at diagnosis was 66.9 years old. The annual incidence rate was 2.06 per 100,000 individuals aged over 50 years. The prevalence rate was 8.21 per 100,000 individuals in 2012. Incidence and prevalence appeared to increase with age. Prednisolone was the most commonly prescribed glucocorticoid. In half of the patients, the daily starting dose was 6∼15 mg as prednisolone equivalents.

Conclusion

This is the first study to investigate the epidemiology of PMR in Korea. The incidence and prevalence appeared to be considerably lower than those in Western populations. Both genetic and environmental factors might influence disease occurrence. In addition, the actual incidence may have been underestimated due to lack of awareness of PMR in clinical practice.

Keywords: Polymyalgia rheumatica, Epidemiology, Korea

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Figure 1.

A total of 1,463 polymyalgia rheumatica (PMR) cases were newly diagnosed between 2008 and 2012. More specifically, 238, 294, 258, 354 and 319 were newly diagnosed each year.

Figure 2.

The incidence rates of PMR per 100,000 individuals in each age group.

Figure 3.

(A) Glucocorticoids prescribed for treating PMR in Korea. (B) Daily glucocorticoids starting doses, as prednisolone equivalents to treat PMR in Korea.

Table 1.

Detailed prevalence rates of PMR according to age and sex

Age	Number of patients (N)			Prevalence rate (per 100,000)
Age	Male	Female	Total	Male	Female	Total
50∼54	34	101	135	1.80	5.29	3.55
55∼59	43	119	162	3.16	8.46	5.86
60∼64	49	122	171	4.64	10.84	7.84
65∼69	73	150	223	8.76	15.32	12.31
70∼74	87	146	233	12.93	16.35	14.88
75∼79	42	93	135	10.23	13.81	12.45
80∼84	25	47	72	13.44	11.48	12.09
≥85	11	21	32	11.61	7.72	8.73

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