Diagnosing fibromyalgia in rheumatoid arthritis: The importance of assessing disease activity

Kılıçarslan, Ayşegül

doi:10.5606/tftrd.2018.1618

Cited by 9 publications

(8 citation statements)

References 24 publications

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“…While Zammurrad et al found that all parameters used when calculating DAS28-S (4 parameters) were higher in RA patients with FM compared to those without FM, some studies found a difference only in terms of subjective parameters, as in to our study. 14 , 17 , 21…”

Section: Discussionmentioning

confidence: 99%

Rheumatoid arthritis activity scores in patients with and without fibromyalgia syndrome

Durmaz

Ilhanli

2021

Ann Saudi Med

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BACKGROUND: Fibromyalgia syndrome (FM) is a systemic disease of unknown etiology, which can cause widespread musculoskeletal pain. In patients with rheumatoid arthritis (RA), FM can cause an additional symptom burden, which can affect some variables on the RA disease activity score 28 (DAS28), a tool that evaluates 28 joints in RA patients. OBJECTIVE: Compare the results of four different versions of the DAS28 and the parameters used to determine disease activity scores in RA patients with and without FM, and determine whether there are treatment differences between RA patients with and without FM. DESIGN: Retrospective, cross-sectional. SETTING: Tertiary hospital. PATIENTS AND METHODS: We identified patients diagnosed with RA between 1 September 2016 and 1 February 2020 and identified patients with and without FM. MAIN OUTCOME MEASURES: Differences between variables in the DAS28 calculations (tender joint count [TJC], patient global assessment [PGA], and others), between patients with and without FM, and differences between patients with and without FM who were using or not using biological agents. SAMPLE SIZE: 381, including 322 females (84.5%). RESULTS: The frequency of FM in RA patients was 25.7% (89 females, 24.6%). In RA patients with FM, the TJC and PGA median values were significantly higher than in patients without FM ( P <.05). The use of corticosteroids and biological therapy in patients with FM was more frequent than in patients without FM ( P <.05). Compared to patients without FM, patients with FM switched treatment more often because of non-response to treatment ( P =.01) Median values of the DAS28 scores (calculated by four different versions of the instrument) in RA patients with FM were higher than in patients without FM ( P <.05). CONCLUSION: The presence of FM in RA patients may affect the subjective variables in different versions of DAS28 scores, causing the disease activity to score higher on the instrument, erroneously indicating worse disease than is actually present. LIMITATIONS: A single center, retrospective study. CONFLICTS OF INTEREST: None.

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Section: Discussionmentioning

confidence: 99%

Rheumatoid arthritis activity scores in patients with and without fibromyalgia syndrome

Durmaz

Ilhanli

2021

Ann Saudi Med

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“…Rheumatoid factor was positive in 67.9% and 75.5% and anti-CCP was positive in 71.7% and 76.5% of the patients with or without FMS, respectively ( P > 0.05). [ 26 ] The current study indicates that there is no significant association between neurological manifestations in patients with RA and autoantibodies positivity. In some cases, but not all, the presence of ACPA and RF autoantibodies can be detected in the pathologic analysis of neurologic lesions in patients with RA.…”

Section: Discussionmentioning

confidence: 55%

Clinical implications of seropositive and seronegative autoantibody status in rheumatoid arthritis patients: A comparative multicentre observational study

Hammam,

El-Husseiny,

Al-Adle

et al. 2024

Rheumatology and Immunology Research

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Background and Objectives Rheumatoid factor (RF) and anti-cyclic citrullinated protein (anti-CCP) have been used to improve the diagnosis and prognosis of rheumatoid arthritis (RA). However, their association with RA disease phenotypes, individually and in combination, is not well studied. The aim of the study was to compare patients’ and disease characteristics, activity and severity in double seronegative (DNRA), single seropositive RF, single seropositive anti-CCP and double seropositive (DPRA) patients. Methods Adults subjects with RA from Egyptian College of Rheumatology (ECR) database who had RF and anti-CCP results available were included. Demographic, clinical features, disease activity score 28 (DAS28), Health Assessment Questionnaire (HAQ) and laboratory data were collected and compared among different RA groups. Results 5268 RA patients with mean age of 44.9±11.6 years, and 4477 (85%) were females. 2900 (55%) had DPRA, 892 (16.9%) had single positive RF, 597 (11.3%) had single positive anti-CCP while 879 (16.7%) had DNRA. Patients with DPRA had significantly high percentage of metabolic syndrome (19.3%, P < 0.001), and functional impairment using HAQ (P = 0.01). Older age (RRR [relative risk ratio]: 1.03, 95%CI: 1.0, 1.0, P = 0.029), greater DAS28 (RRR: 1.51, 95%CI: 1.2, 1.9, P < 0.001), higher steroid use (RRR: 2.4, 95%CI: 1.36, 4.25, P = 0.002) were at higher risk of DPRA while longer disease duration (RRR: 1.08, 95%CI: 1.01, 1.16, P = 0.017) and fibromyalgia syndrome (RRR: 2.54, 95%CI: 1.10, 5.88, P = 0.028) were associated with higher odds of single positive RF status. Conclusion Dual antibody-positive status has higher disease activity and severity, and higher chance of development of metabolic syndrome; highlighting the implicated role of inflammation, atherogenesis and cardiovascular disease risk in RA.

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“…In line with our findings, Bazzichi et al [6] showed that FM prevalence in RA patients is about 21%, with a range of 4.9-52.4%. In another study, Klçarslan et al [30] found that FM frequency was higher in patients with RA [35.1%] compared to the control group [19.5%].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Fibromyalgia in Patients with Rheumatoid Arthritis and its Impact on Disease Activity, Functional Level, and Psychological Status

Azzam

Lamlom²,

Khalifa³

2022

International Journal of Medical Arts

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Article informationBackground: Rheumatoid arthritis [RA] is a type of progressive disease characterised by inflammation in the synovial tissues resulting in deformity and functional impairment. Fibromyalgia [FM] is a well-known comorbidity in RA which may change the physical evaluation and incorrectly affect the degree of RA treatment. The Aim of the work:To evaluate FM in patients with RA and its impact on disease activity, functional, and psychological status. Patients and methods: The study included 1200 patients with RA. Individuals were divided based on their FM status. All patients were assessed clinically and evaluated by the Health Assessment Questionnaire for pain [HAQ-pain], the Multidimensional Assessment of Fatigue [MAF], the Pittsburgh Sleep Quality Index [PSQI], the Beck Depression Inventory-II [BDI-II], and the Modified Health Assessment Questionnaire for functional disability [MHAQ]. The Disease Activity Score with ESR [DAS28-ESR] was used to assess RA disease activity in 28 joints. FM and RA were diagnosed using the criteria of the American College of Rheumatology [ACR].Results: Among our patients with RA, the prevalence of FM was 37%. Patients with FM had an increased proportion of females, were older, had a more prolonged disease duration, and had more protracted morning stiffness than patients without FM. Scores of DAS28 were considerably higher in RA patients with FM in comparison to those with only RA [5.70 ±1.19, 4.48 ± 1.26; P < 0.001] respectively. Concurrent FM also had worse HAQ-pain, MHAQ, fatigue, and depression scores, as well as more frequent sleep problems. Conclusion:In patients with RA, coexisting FM was associated with greater activity of the disease and impairments in functional level. FM was linked to higher rates of depression and fatigue, as well as an increased prevalence of sleep problems. The recognition and evaluation of such psychiatric disorders may help patients with RA achieve therapeutic improvement or remission.

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Diagnosing fibromyalgia in rheumatoid arthritis: The importance of assessing disease activity

Cited by 9 publications

References 24 publications

Rheumatoid arthritis activity scores in patients with and without fibromyalgia syndrome

Rheumatoid arthritis activity scores in patients with and without fibromyalgia syndrome

Clinical implications of seropositive and seronegative autoantibody status in rheumatoid arthritis patients: A comparative multicentre observational study

The Prevalence of Fibromyalgia in Patients with Rheumatoid Arthritis and its Impact on Disease Activity, Functional Level, and Psychological Status

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