RT Journal Article
SR Electronic
T1 Evaluation of the impact of concomitant fibromyalgia on TNF alpha blockers’ effectiveness in axial spondyloarthritis: results of a prospective, multicentre study
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 533
OP 540
DO 10.1136/annrheumdis-2017-212378
VO 77
IS 4
A1 Anna Moltó
A1 Adrien Etcheto
A1 Laure Gossec
A1 Nadia Boudersa
A1 Pascal Claudepierre
A1 Nicolas Roux
A1 Lucie Lemeunier
A1 Antoine Martin
A1 Lartitia Sparsa
A1 Pascal Coquerelle
A1 Martin Soubrier
A1 Serge Perrot
A1 Maxime Dougados
YR 2018
UL http://ard.bmj.com/content/77/4/533.abstract
AB Objective To describe the prevalence of fibromyalgia (FM) in an axial spondyloarthritis (axSpA) population and to confirm that concomitant FM had a negative impact on tumour necrosis factor blockers’ (TNFb) response.Design Prospective observational study with two visits 3 months apart.Patients Adult patients with AxSpa initiating a TNFb.Study groups FM was defined by the Fibromyalgia Rapid Screening Tool (FiRST) at baseline and also by a sustained positive FiRST (both visits) and by a fulfilment of the 1990 American College of Rheumatology criteria for FM.Statistical analysis Prevalence of FM; evaluation of the impact of a concomitant FM on TNFb response (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI 50) as primary endpoint), adjusted by factors known to have an impact on TNFb response.Results Among the 508 patients included in the main analysis, 192 (37.8%) were screened at baseline as FM. Percentage of success after 12 weeks of treatment was lower in the FM group for most of the effectiveness endpoints (eg, BASDAI 50: 45.3% vs 54.1% in the FM/not FM groups according to the FiRST), except for the C reactive protein change endpoints which were not different across groups.Conclusion This study confirms that FM coexists in patients with axSpA and that its presence seems to have a negative impact on TNFb response, which seems more related to the self-reported instruments used in its evaluation, rather than a different treatment effect of the molecule in this subgroup of patients.