Concomitant fibromyalgia in patients with rheumatoid arthritis


Authors: J. Tomš;  T. Soukup;  P. Bradna;  Z. Hrnčíř
Authors‘ workplace: Oddělení revmatologie a klinické farmakologie, 2. interní klinika Lékařské fakulty UK a Fakultní nemocnice Hradec Králové
Published in: Čes. Revmatol., 17, 2009, No. 3, p. 120-126.
Category: Original Papers

Overview

Objective:
The aim of the study was to evaluate the impact of concomitant fibromyalgia (FM) on patients with rheumatoid arthritis (RA), and to find out differences in clinical manifestations, laboratory parameters, quality of life and functional disability.

Methods:
120 patients with RA were examined for the presence of FM according to the criteria of American College of Rheumatology, and subsequently, the group of RA patients with FM was compared to the group of RA patients without FM. The following parameters were recorded or examined: demographic data, comorbidities and current antirheumatic therapy, selected laboratory parameters, X-ray of hand and foot joints and 28-joints Disease Activity Score (DAS-28). Each of the patients filled in several questionnaires: Health Assessment Questionnaire, Short Form-36 Health Survey, Fibromyalgia Impact Questionnaire and Zung self-rating depression scale.

Results:
Twenty-five (20.8%) patients with RA met the classification criteria for FM (4 males, 21 females), in 88% of cases, it was a newly determined diagnosis of FM. Patients with RA and associated FM had a significantly worse quality of life, a higher level of disability, increased RA activity according to DAS-28 index, and were treated with a higher dose of glucocorticoids. Inflammatory laboratory markers, the presence of joint erosion, and disease modifying antirheumatic drugs were comparable in both groups. FM was significantly more frequent in patients with RA, and with a negativity of serum rheumatoid factor (RF).

Conclusion:
FM is a relatively frequent, albeit underdiagnosed disease associated with RA. It results in significant worsening of quality of life and disability; moreover, it influences the clinical assessment of RA activity.

Key words:
fibromyalgia, rheumatoid arthritis, activity assessment, quality of life, disability


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Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
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