Association of concomitant fibromyalgia with worse disease activity score in 28 joints, health assessment questionnaire, and short form 36 scores in patients with rheumatoid arthritis

Ranzolin, Aline; Brenol, João Carlos Tavares; Bredemeier, Markus; Guarienti, Jairo; Rizzatti, Marcele Osório; Feldman, Daniel; Xavier, Ricardo Machado

doi:10.1002/art.24430

Cited by 170 publications

(149 citation statements)

References 16 publications

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“…The strong association between remaining pain and functional impairment at baseline was not a surprising finding, as disability and pain are very strongly correlated 16. Previous data have implicated disability as a strong marker for chronic pain 17, and research earlier showed that RA patients with concomitant fibromyalgia display increased disability compared to patients without fibromyalgia 18, 19. From our data, we could not detect prevalence of fibromyalgia, which was not in the scope of the study, but earlier investigations have shown that the prevalence of chronic widespread pain may be increased by 10‐fold in RA 18.…”

Section: Discussionmentioning

confidence: 90%

Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate

Altawil

Saevarsdóttir

Wedrén

et al. 2016

Arthritis Care & Research

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ObjectiveTo investigate the frequency of remaining pain in early rheumatoid arthritis (RA) after 3 months of treatment with methotrexate as the only disease modifying antirheumatic drug, with a special focus on patients with a good clinical response.MethodsThe study base was cases reported to a population‐based early RA cohort who had followup data from the Swedish Rheumatology Quality Register (n = 1,241). The Disease Activity Score in 28 joints European League Against Rheumatism (EULAR) response criteria were used to evaluate clinical response to treatment as good, moderate, and no response. The primary end point was remaining pain at the 3‐months followup visit, defined as pain >20 mm on a 100‐mm visual analog scale (VAS).ResultsRemaining pain in spite of a EULAR good response at followup was associated with higher baseline disability, using the Health Assessment Questionnaire (adjusted odds ratio [OR] 2.2 [95% confidence interval (95% CI) 1.4–3.4] per unit increase), and less baseline inflammation, using the erythrocyte sedimentation rate (adjusted OR 0.81 [95% CI 0.70–0.93] per 10‐mm increase). Similar associations were detected for remaining pain at followup in spite of low inflammatory activity, defined as a C‐reactive protein level <10. Increase in VAS pain during the treatment period was observed in 19% of the whole cohort, with frequencies in the EULAR response groups of 9% (good response), 15% (moderate response), and 45% (no response).ConclusionThese results are in line with the hypothesis that a subgroup of early RA patients exhibits pain that is not inflammatory mediated, where alternative treatment strategies to traditional antiinflammatory medications need to be considered.

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Section: Discussionmentioning

confidence: 90%

Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate

Altawil

Saevarsdóttir

Wedrén

et al. 2016

Arthritis Care & Research

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“…Some studies reported that depression is associated with reduced health status, as well as higher pain, fatigue, and reduced QOL (9,21,25). According to the present study, depression which appears to be a key factor affecting QOL should be prevented.…”

Section: Atapoor Et Al (15) 2002mentioning

confidence: 56%

Quality of Life and Its Predictors Among Iranian Patients With Rheumatoid Arthritis: A Systematic Review

Shokri

Mottaghi

Qolipour

et al. 2015

Jentashapir J Health Res

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Context: Rheumatoid Arthritis (RA) is a chronic disease accompanied by physical disabilities and a number of co-morbidities; it leads to remarkable economic burden, reduced productivity, and deteriorated quality of life (QOL). Objectives: The current study aimed to provide a clear view of quality of life among the Iranian patients with Rheumatoid Arthritis through a systematic review. Data Sources: The current study was conducted as a systematic literature review on the articles published from 2000 to 2013 in data bases such as: Google scholar, Science Direct, PubMed, IRANDOC, SID and Medlib and by keywords: quality of life, Rheumatoid Arthritis, Iran and, their Persian equivalents. Study Selection: Finally, 10 articles were selected out of the 2065 assessed ones. Data Extraction: In the first step, the extracted results were summarized in the extraction table, and then analyzed using the Forest plot. Results: Based on the Forest plot, six studies on the quality-of-life, met the inclusion criteria. Total QOL score was 47.5. In the reviewed articles (n = 10), different variables and factors were reported to affect the QOL in patients with RA. The most important factors affecting QOL were demographic factors, depression, and complications of RA, etc. Conclusions: Due to the chronic nature of RA, promoting the QOL and adherence to therapies could be achieved through convincing the patients. Therefore, identification of weak points and planning for them at all levels; from individual to the community level is suggested.

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“…), депрессия, фи-бромиалгия, особенности психики, вторичные дегенера-тивные изменения в суставах и др. [94][95][96][97], что приводит к некорректной оценке активности заболевания [94]. Примечательно, что у пациентов с РА, имеющих вторич-ную фибромиалгию, по данным УЗИ признаки воспале-ния суставов выражены в меньшей степени, чем у боль-ных без фибромиалгии при сходных значениях индекса DAS [98].…”

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Rheumatoid Arthritis: The Problems of Remission and Therapy Resistance

Nasonov¹,

Олюнин²,

Лила³

2018

rsp

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Ревматоидный артрит (РА) -иммуновоспалительное (аутоиммунное) ревматическое заболевание неизвест-ной этиологии, характеризующееся хроническим эрозивным артритом и системным поражением внутрен-них органов, приводящее к ранней инвалидности и сокращению продолжительности жизни пациентов. Не-смотря на достигнутые успехи в лечении РА, связанные с разработкой новых лекарственных препаратов и совершенствованием стратегии лечения, позволяющие добиться ремиссии у многих пациентов, остается много теоретических и клинических проблем, касающихся как определения понятия «ремиссия», ее харак-теристики и типов, так и подходов к оптимальной тактике «симптоматической» и «патогенетической» лекар-ственной терапии на разных стадиях болезни, применение которой позволит быстро индуцировать состоя-ние ремиссии и поддерживать ее в долгосрочной перспективе. Необходимы дальнейшие исследования, на-правленные на изучение природы гетерогенности патогенетических механизмов РА и подходов к ранней ди-агностике, совершенствование методов мониторинга активности заболевания, биомаркеров эффективности и резистентности к терапии и, наконец, разработку дифференцированной терапии, в том числе связанной с поиском новых «терапевтических» мишеней. Rheumatoid arthritis (RA) is an immunoinflammatory (autoimmune) rheumatic disease of unknown etiology, which is characterized by chronic erosive arthritis and systemic visceral organ damage that results in early disability and shorter patient survival. Despite RA treatment advances associated with the design of novel drugs and the improvement of treatment strategies to achieve remission in many patients, there are still many theoretical and clinical problems concerning both the definition of the concept of remission, its characteristics and types and approaches to the optimum policy of symptomatic and pathogenetic drug therapy at different stages of the disease, the use of which will be able to rapidly induce and maintain remission in the long-term. Further investigations are needed to study the nature of heterogeneity of pathogenetic mechanisms of RA and approaches to early diagnosis, to improve methods for monitoring disease activity and biomarkers for the efficiency of and resistance to therapy and, finally, to develop differentiation therapy, including those related to a search for new therapeutic targets.

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Association of concomitant fibromyalgia with worse disease activity score in 28 joints, health assessment questionnaire, and short form 36 scores in patients with rheumatoid arthritis

Cited by 170 publications

References 16 publications

Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate

Remaining Pain in Early Rheumatoid Arthritis Patients Treated With Methotrexate

Quality of Life and Its Predictors Among Iranian Patients With Rheumatoid Arthritis: A Systematic Review

Rheumatoid Arthritis: The Problems of Remission and Therapy Resistance

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