Fatigue as a precursor to polymyalgia rheumatica: an explorative retrospective cohort study

Figures & data

Table 1. Rates of fatigue and sleep consultations in PMR and non-PMR patients.

	PMR patients	Non-PMR patients	Main analysis*, HR (95% CI)
	(n = 549)	(n = 2196)	Single event	Multiple events
Fatigue, frequency (rate†)
Pre-diagnosis	33 (0.425)	80 (0.245)	1.74 (1.16–2.62)	1.95 (1.23–3.08)
Post-diagnosis	31 (0.372)	81 (0.251)	1.41 (0.93–2.13)	1.58 (0.95–2.63)
Sleep problems, frequency (rate†)
Pre-diagnosis	15 (0.188)	53 (0.161)	1.15 (0.65–2.06)	1.82 (0.85–3.93)
Post-diagnosis	16 (0.189)	68 (0.210)	0.88 (0.51–1.53)	0.58 (0.32–1.06)

PMR, Polymyalgia rheumatica; HR, hazard ratio; CI, confidence interval.

* Adjusted for opposite condition in same time period and for consultation for same condition in ‘pre-diagnosis’ period (post-diagnosis analyses only).

† Per 10 000 person-years.

Table 2. Rates of fatigue and sleep consultations in PMR patients and non-PMR patients in the sensitivity analysis.

	PMR patients	Non-PMR patients	Sensitivity analysis*
	(n = 422)	(n = 2196)	Single HR (95% CI)	Multiple HR (95% CI)
Fatigue, frequency (rate†)
Pre-diagnosis	26 (0.414)	80 (0.245)	1.71 (1.10–2.67)	1.99 (1.20–3.30)
Post-diagnosis	28 (0.445)	81 (0.251)	1.67 (1.09–2.56)	1.60 (0.96–2.68)
Sleep problems, frequency (rate†)
Pre-diagnosis	12 (0.187)	53 (0.161)	1.16 (0.61–2.19)	1.80 (0.74–4.35)
Post-diagnosis	10 (0.155)	68 (0.210)	0.73 (0.38–1.43)	0.46 (0.22–0.94)

PMR, Polymyalgia rheumatica; HR, hazard ratio; CI, confidence interval.

* Adjusted for opposite condition in same time period and for consultation for same condition in ‘pre-diagnosis’ period (post-diagnosis analyses only).

† Per 10 000 person-years.

Table 3. Hazard ratios (with 95% confidence intervals) stratified by time between index date and fatigue/sleep consultations (stringent PMR definition).

	0–3 months	3–6 months	6–9 months	9–12 months	1–2 years	2–10 years
Fatigue
Pre-diagnosis
Single	1.36 (0.38–4.79)	1.46 (0.31–6.88)	19.71 (2.19–177.6)	6.79 (1.51. 30.46)	1.71 (0.47–6.25)	1.12 (0.56–2.12)
Multiple	1.09 (0.30–3.92)	1.30 (0.27–6.14)	39.05 (4.49–340.0)	9.99 (2.25–44.43)	1.66 (0.41–6.72)	1.23 (0.56–2.70)
Post-diagnosis
Single	1.01 (0.22–4.61)	0.00 (0.00–0.00)	0.00 (0.00–0.00)	4.92 (1.00–24.15)	2.52 (1.08–5.88)	1.70 (0.95–3.04)
Multiple	1.01 (0.20–5.12)	1.29 (0.14–11.46)	0.00 (0.00–0.00)	11.37 (2.18–59.28)	2.07 (0.80–5.32)	1.53 (0.79–2.97)
Sleep
Pre-diagnosis
Single	0.78 (0.10–6.32)	0.83 (0.10–6.72)	1.93 (0.38–9.91)	4.98 (0.31–79.07)	1.16 (0.25–5.40)	1.06 (0.41–2.78)
Multiple	0.78 (0.10–6.34)	0.83 (0.10–6.71)	1.38 (0.27–6.97)	2.49 (0.23–27.36)	1.41 (0.40–5.02)	2.35 (0.88–6.32)
Post-diagnosis
Single	0.00 (0.00–0.00)	1.04 (0.12–8.93)	0.00 (0.00–0.00)	0.00 (0.00–0.00)	0.76 (0.17–3.36)	0.96 (0.43–2.17)
Multiple	0.00 (0.00–0.00)	0.74 (0.08–6.77)	0.00 (0.00–0.00)	0.00 (0.00–0.00)	0.45 (0.10–2.02)	0.55 (0.24–1.31)

PMR, Polymyalgia rheumatica.