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THU0553 Relationship between Active Disease and Fibromyalgia in Patients with Rheumatoid Arthritis
  1. A. Kılıcaslan1,
  2. F.G. Yurdakul1,
  3. H. Bodur2
  1. 1Physical Medicine and Rehabilitation, Ankara Numune Training and Research Hospital
  2. 2Physical Medicine and Rehabilitation, Yildirim Beyazit University, Ankara, Turkey

Abstract

Background Rheumatoid arthritis (RA) is an inflammatory disease characterized by erosive synovitis. Fibromyalgia syndrome (FMS) known with widespread pain, fatigue, sleep disturbances and mood disorders. FMS frequency increased in patients with RA.

Objectives This study aimed to assess the prevalence of FMS in patients with RA and to analyse the relationship between disease activity and FMS.

Methods The study included 151 RA patients and 77 controls without inflammatory rheumatic diseases. RA patients and the control group were evaluated with 2010 ACR criteria for FMS. Participants were divided into 4 groups according to presence of RA and FMS (Group 1: RA+, FMS+; Group 2: RA+, FMS-; Group 3: RA-, FMS+; Group 4: RA-, FMS-). Demographic characteristics, laboratory results, VAS pain, DAS 28, and HAQ scores were compared between 4 groups. RA patients were classified as in remission or without according to the DAS 28 score (DAS 28≤2.6 and>2.6 respectively) and FMS evaluated.

Results The mean age and sex distribution were similar between the RA patients and controls. FMS was found in 35.1% of RA patients and 19.5% of controls (p<0.05). The highest VAS pain and DAS 28 scores were in the group 1 and group 3 between the sub-groups (Table 1). FMS were compared between controls, RA patients in remission and active disease. FMS ratio was 19.5%; 8.1%; 53.9% respectively (p<0.05). Four parameters (ESR, tender joints, swollen joints, patient global assessment) of DAS 28 were higher in RA patients with active disease (p<0.05).

Table 1.

The evaluation of disease activity and pain in patients who were divided into four groups according to the presence rheumatoid arthritis and fibromyalgia

Conclusions FMS is more common in the patients with RA than the general population therewithal FMS found more common in the patients with active RA. When DAS 28 parameters are analyzed, objective values (ESH; swollen joint) were higher as subjective values (pain) in this group. In conclusion increased widespread pain and disruption of the sleep quality because of inflammation may facilitate the diagnosis of FMS.

  1. Zammurrad S, Munir W, Farooqi A. Disease activity score in rheumatoid arthritis with or without secondary fibromyalgia. J Coll Physicians Surg Pak. 2013 Jun;23(6):413–7.

  2. Toms J, Soukup T, Bradna P, Hrncir Z. Disease activity composite indices in patients with rheumatoid arthritis and concomitant fibromyalgia. J Rheumatol. 2010 Feb;37(2):468

Disclosure of Interest None declared

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