Background Takayasu’s arteritis (TA) is a chronic inflammatory large-vessel vasculitis of the aorta and its major branches. To our knowledge, there is no data about the frequency of Fibromyalgia Syndrome (FM), a systemic pain disorder, in TA.
Objectives We aimed to investigate the frequency of FMS in TA defined according to the 2010 ACR Preliminary Diagnostic Criteria for FM. The correlation between ACR-1990 and 2010 FM criterias and the effect of patient-reported outcomes (PROs) such as Health Assessment Questionnaire (HAQ), Multidimensional Assessment of Fatigue Scale (MAF), Short-Form 36-item survey (SF-36) and anxiety and depression scales on FM were also analysed.
Methods We studied 42 patients with TA (F/M: 38/4, mean age: 30.8 years) and 20 (F/M: 11/9, mean age:32.8 years) healthy controls (HC). Fourteen patients (33,3%) were clinically active. All patients were examined for FM tender points (ACR 1990 criteria for classification for FM) by two observer (kappa: 0.648) and asked to complete new ACR 2010 FM questionnaire for FM (ref1). PROs were used to assess quality of life together with HAQ.
Results Seven (16.6%) TA patients and 3 HC (15%) met the ACR-2010 FM criteria, whereas only 3 (7,1%) patients and no controls (0%) met the 1990 Criteria. No significant differences regarding the FM frequency were present according to both ACR-2010 and 1990 FM criterias between TA and HC. No differences were also observed for the 2 subscales of 2010 criteria, the Widespread Pain Index (WPI) and the Symptom Severity (SS) scale among the groups. FM presence was also similar between active and inactive patients (p:0,143).The SF-36 physical component score (PCS) were significantly lower [TA:45,85 (18-62), HC: 55,5 (31-59), p=0.009] and HAQ score significantly higher in patients with TA [0,175 (0- 2,35)]compared to HC[0,005 (0-0,45)] (p<0,001). No differences were present in other PROs (Table 1).
WPI correlate significantly with tender points (r=0,728, p<0,001), MAF (r=0,692, p<0,001), HAQ (r=0,539, p<0,001), anxiety (r=0,442, p<0,001), depression (r=0,475, p<0,001), PCS (r= -0,629, p<0,001) and MCS (r=-0, 468, p<0,001). SSS correlate significantly with tender points (r=0,508, p<0,001), MAF (r=0,773, p<0,001), HAQ (r=0,4999, p<0,001), anxiety (r=0,618, p<0,001), depression (r=0,498, p<0,001), PCS (r= -0,617, p<0,001) and MCS (r=-0,629, p<0,001).
Conclusions The frequency of FM is similar to general population in patients with Takayasu arteritis. The new ACR-2010 FM criteria seem to be more sensitive than the ACR-1990 criteria for diagnosis. Although other PROs also does not differ from HC, the new FM criteria subscales WPI and SSS significantly correlated with scales such as SF-36, MAF, anxiety and depression scale and HAQ in TA, suggesting that in a minority of patients with FM and TA, PROs are affected with FM presence.
Wolfe F, Clauw DJ, Fitzcharles MA, et al. The ACR preliminary diagnostic criteria forfibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010 May;62(5):600-10.
Disclosure of Interest None Declared
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