Fibromyalgia in patients with rheumatoid arthritis is associated with higher scores of disability

Naranjo, Antonio; Ojeda, Soledad; Francisco, Félix; Erausquin, Celia; Rúa-Figueroa, Íñigo; Rodríguez‐Lozano, Carlos

doi:10.1136/ard.61.7.660

Cited by 54 publications

(40 citation statements)

References 10 publications

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“…While each was jointly significantly related to disability (P Ͻ 0.0001, R 2 ϭ 0.5) ( Table 2), pain emerged as the strongest independent factor contributing to disability at time 1. It is known that fibromyalgia commonly coexists in individuals with RA and can be a source of significant pain in this population (18). Since 39 (16%) of 251 patients in our cohort fulfilled the criteria for fibromyalgia, we wanted to clarify whether the presence of this condition might have influenced the observed significance of self-reported pain on disability.…”

Section: Resultsmentioning

confidence: 99%

“…Several studies in RA, predominantly involving white Eu-ropeans and some Northern Americans, have confirmed the important contribution of disease activity, duration, seropositivity, and the presence of radiographic damage (erosions) to disability (13)(14)(15)(16). In similar populations, the presence of secondary fibromyalgia averages 15% and may inflate self-reported disability (17)(18)(19)(20). These factors and their contributions to functional disability in large cohorts of US Hispanics have not been adequately reported.…”

Section: Introductionmentioning

confidence: 99%

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Correlates and predictors of disability in vulnerable US Hispanics with rheumatoid arthritis

Karpouzas¹,

Dolatabadi²,

Moran³

et al. 2012

Arthritis Care & Research

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Objective. US Hispanics with rheumatoid arthritis experience worse functional outcomes compared to whites. The determinants of disability, however, are not well established in large Hispanic cohorts. In the present report, we identified factors associated with disability in a cross-sectional design, and evaluated their individual contributions to disability over time. Methods. Two hundred fifty-one Hispanic subjects from a single center were evaluated. Disease activity, serologies, radiographs, treatments, irreversible articular damage (defined as subluxation, arthrodesis, fusion, or prosthesis), and joint replacement surgeries were recorded. Self-reported disability (Health Assessment Questionnaire disability index), patient pain by a visual analog scale, and depression assessments were collected. Cross-sectional factors associated with disability were identified, and their effects on future disability were evaluated in a subgroup of 114 patients assessed 6 months later. Results. Six parameters were independently related to disability cross-sectionally: pain was the strongest (P < 0.0001), followed by irreversible articular damage, disease activity, depression, age, and fibromyalgia (P < 0.03 for all). Baseline parameters predicting disability 6 months later included, in decreasing significance, irreversible articular damage (P ‫؍‬ 0.004), depression, disease activity, age, and pain (all P < 0.04). Conclusion. In cross-sectional analysis, self-reported pain had the strongest relationship with disability; however, factors such as irreversible articular damage, depression, and disease activity were more important in predicting future disability. Most of these factors are amenable to targeted interventions and should be addressed in an effort to improve functional outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Correlates and predictors of disability in vulnerable US Hispanics with rheumatoid arthritis

Karpouzas¹,

Dolatabadi²,

Moran³

et al. 2012

Arthritis Care & Research

View full text Add to dashboard Cite

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“…There are evidences that presence of FMS in RA patients reduce the QoL, increases functional impairment and HAQ scores. [21,[27][28][29][30][31][32] In our study, HAQ scores were higher in patients with RA and FMS together. Quality of life was compared between the four groups.…”

Section: Discussionmentioning

confidence: 78%

“…While FMS incidence was reported between 2.2% and 6.6% in the general population, [21][22][23] it was found between 6.6% and 22.4% in patients with RA. [9,24,25] Although the prevalence of FMS was 1.1% with 1990 criteria in Vincent et al's study, [14] the frequency of FMS in a random sample from the same patient group was 6.36% using 2010 ACR criteria.…”

Section: Discussionmentioning

confidence: 99%

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

Kılıçarslan¹

2018

Turk J Phys Med Rehab

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Objectives: This study aims to evaluate fibromyalgia syndrome (FMS) incidence based on 2010 American College of Rheumatology (ACR) criteria in rheumatoid arthritis (RA) patients and the association between FMS with disease activity, functional status and quality of life (QoL). Patients and methods:The study included 151 RA patients (32 males, 119 females; mean age 52.4±12.7 years; range 21 to 82 years) and 77 controls (13 males, 64 females; mean age 53.7±10.2 years; range 33 to 73 years). Individuals were classified into four groups based on presence of RA and FMS. Group 1 included patients with both RA and FMS (n=53), group 2 included patients with RA and without FMS (n=98), group 3 included controls with FMS (n=15), and group 4 included controls without FMS (n=62). Demographic characteristics, morning stiffness (MS), pain, Disease Activity Score 28 (DAS28), functional and QoL scores were compared among the groups.Results: No significant differences were found between the four groups as regards the mean age and gender distribution (p>0.05). Higher pain, MS, DAS28, and QoL scores in the groups with FMS drew attention. While FMS was found in 8.1% of RA patients with remission, it was found in 53.9% of patients with active RA, and in 19.5% of controls. Conclusion:Although FMS incidence in patients with RA was higher compared to controls without inflammatory disease, FMS evaluated with 2010 ACR diagnostic criteria was found to be common in the general population. DAS28 and inflammatory markers were higher in RA patients with FMS; thus, it has been concluded that sleep disorder and widespread pain caused by active disease may facilitate the diagnosis of FMS.

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“…DAS28-4v is calculated by using swollen joint count (SJC), tender joint count (TJC), erythrocyte sedimentation rate (ESR), and the Patient Global Assessment (PGA) (2,11). If there is concomitant FM in the patient with RA, then it is more difficult to evaluate the disease activity because the pain and functional disability scores are higher in these patients (12).…”

Section: Introductionmentioning

confidence: 99%

Comparative Results of DAS28 and Quality of Life in Patients with Rheumatoid Arthritis and Fibromyalgia

et al. 2010

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Objective: In the present study, we compared Disease Activity Score 28-4v (DAS28-4v) and quality of life by using Short Form-36 (SF-36) in patients with rheumatoid arthritis (RA) and fibromyalgia (FM). Materials and Methods:The swollen joint count (SJC) and the tender joint count (TJC) of 79 patients with RA and 34 patients with FM, the Patient Global Assessment (PGA) with 100 mm visual analog scale (VAS), and erythrocyte sedimentation rates (ESR) were recorded and DAS28-4v scores were calculated. The quality of life in both groups was evaluated by using SF-36. Result: The mean DAS28-4v score of the RA group was 3. 63±1.52 (0.77-7.40) and of the FM group was 2. 42±0.73 (0.57-3.86), and the difference between groups was statistically significant (p<0.001). In the Principal Component Analysis (PCA), in the RA group, the components that most affected DAS28-4v were TJC and SJC, while in the FM group, these were SJC and PGA. Significant differences were detected between the two groups in most SF-36 subgroups, except in the general mental health, social functioning and social role limitation subgroups. In the FM group, the physical function subgroup was significantly higher (p<0.001). Conclusion: Although there is no objective injury such as inflammation or joint damage, FM can decrease the quality of life to the same extent as RA. FM, which is a non-inflammatory disease, can cause high rates in DAS28-4v due to the fact that there are many subjective complaints such as the TJC and the PGA. The intervening infections during the evaluation of disease activity in RA or concomitant diseases like FM might cause fluctuations in the DAS28-4v score. (Turk J Rheumatol 2010; 25: 179-83

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Fibromyalgia in patients with rheumatoid arthritis is associated with higher scores of disability

Cited by 54 publications

References 10 publications

Correlates and predictors of disability in vulnerable US Hispanics with rheumatoid arthritis

Correlates and predictors of disability in vulnerable US Hispanics with rheumatoid arthritis

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

Comparative Results of DAS28 and Quality of Life in Patients with Rheumatoid Arthritis and Fibromyalgia

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