Impact of Fibromyalgia on Disease activity in Inflammatory Arthritis: A Cohort Study Conducted at Tertiary Care Hospital of Peshawar, Pakistan

Authors

  • Waqar Hayat Department of Rheumatology, MTI Lady Reading Hospital, Peshawar Pakistan
  • Suleman Khan Department of Rheumatology, Afridi Medical Centre, Peshawar Pakistan
  • Saqib Adnan Department of Rheumatology, MTI Lady Reading Hospital, Peshawar Pakistan
  • Zia Ud Din Department of Rheumatology, MTI Lady Reading Hospital, Peshawar Pakistan
  • Syed Hassan Mustafa Department of Rheumatology, MTI Lady Reading Hospital, Peshawar Pakistan
  • Ibrar Hussain Department of Rheumatology, MTI Lady Reading Hospital, Peshawar Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i5.8935

Keywords:

Ankylosing spondylitis, Fibromyalgia, Inflammatory arthritis, Psoriatic arthritis, Rheumatoid arthritis

Abstract

Objective: To determine the frequency of fibromyalgia in patients with inflammatory arthritis and to evaluate the impact of fibromyalgia treatment on disease activity in these patients.

Study Design: Prospective cohort study.

Place and Duration of Study: Rheumatology Division, Lady Reading Hospital, Peshawar Pakistan, from Apr to Dec 2021.

Methodology: A total of 400 patients were enrolled in the study of which 320 were diagnosed with rheumatoid arthritis, 55 with ankylosing spondylitis and 25 with psoriatic arthritis. The diagnosis of fibromyalgia was made with 2016 American College of Radiology Criteria and patients were classified according to the presence or absence of fibromyalgia. Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte Sedimentation Rate (DAS28-ESR), Bath Ankylosing Spondylitis Disease Activity Index and Disease Activity in Psoriatic Arthritis Score-28 were recorded for rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis, respectively. Patients of fibromyalgia were treated by either pregabalin or duloxetine with 3-month follow-up. Patients with Widespread Pain Index <7 and Symptoms Severity Scale <5 after treatment for 3 months were labeled as responders.

Results: Fibromyalgia was present in 90(28.1%) patients with Rheumatoid Arthritis, 14(25.5%) with ankylosing spondylitis and 8(32%) with Psoriatic arthritis. Fibromyalgia was more common in Rheumatoid Arthritis patients whose disease duration exceeded 5 years (p-value <0.001). Similarly, obesity significantly contributed to Fibromyalgia development in Rheumatoid Arthritis (p-value <0.001) but not in Ankylosing spondylitis and Psoriatic arthritis patients. Disease duration >5 years, obesity, female gender and rising age increased the odds of developing Fibromyalgia in ...

Conclusion: Patients with concomitant Fibromyalgia presented higher 

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References

Borchers AT, Gershwin ME. Fibromyalgia: a critical and comprehensive review. Clin Rev Allergy Immunol 2015; 49(2): 100-151.

https://doi.org/10.1007/s12016-015-8509-4

Queiroz LP. Worldwide epidemiology of fibromyalgia. Curr Pain Headache Rep 2013; 17(8): 1-6.

https://doi.org/10.1007/s11916-013-0346-5

Puche Larrubia M, Castro Villegas M, Ortega Castro R, Garrido-Castro J, Font-Ugalde P, Escudero-Contreras A, et al. ASAS Health Index in patients with spondyloarthritis and its association with disease activity and disease burden including fibromyalgia. Reumatol Clin 2021; 39(130): S82-S88.

https://doi.org/10.1016/j.reuma.2020.11.008

Zhao SS, Duffield SJ, Goodson NJ. The prevalence and impact of comorbid fibromyalgia in inflammatory arthritis. Best Pract Res Clin Rheumatol 2019; 33(3): 101423.

https://doi.org/10.1016/j.berh.2019.101423

Coskun Benlidayi I. Fibromyalgia interferes with disease activity and biological therapy response in inflammatory rheumatic diseases. Rheumatol Int 2020; 40(6): 849-858.

https://doi.org/10.1007/s00296-020-04583-1

D’Apuzzo MR, Cabanela ME, Trousdale RT, Sierra RJ. Primary total knee arthroplasty in patients with fibromyalgia. Orthopedics 2012; 35(2): e175-e178.

https://doi.org/10.3928/01477447-20120123-10

Haidri LA, Firwana R. Fibromyalgia complicating disease management in rheumatoid arthritis. J Coll Physicians Surg Pak 2014;24(6):424-427.

Calandre EP, Rico-Villademoros F, Slim M. An update on pharmacotherapy for the treatment of fibromyalgia. Expert Opin Pharmacother 2015; 16(9): 1347-1368.

https://doi.org/10.1517/14656566.2015.1057117

Mülkoğlu C, Ayhan FF. The impact of coexisting fibromyalgia syndrome on disease activity in patients with psoriatic arthritis and rheumatoid arthritis: A cross-sectional study. Mod Rheumatol 2021; 31(4): 827-833.

https://doi.org/10.1080/14397595.2020.1793737

Duffield SJ, Miller N, Zhao S, Goodson NJ. Concomitant fibromyalgia complicating chronic inflammatory arthritis: a systematic review and meta-analysis. Rheumatology 2018; 57(8): 1453-1460. https://doi.org/10.1093/rheumatology/key053

Elsawy NA, Helal AMH, Abd ElHamid HA, Abdel-Fattah YH. Fibromyalgia in patients with psoriatic arthritis: Impact on disease activity indices, fatigue and health-related quality of life. Int J Rheum Dis 2021; 24(2): 189-196.

https://doi.org/10.1111/1756-185X.13991

D'Onghia M, Ciaffi J, Lisi L, Mancarella L, Ricci S, Stefanelli N, et al. Fibromyalgia and obesity: a comprehensive systematic review and meta-analysis. Semin Arthritis Rheum 2021; 51(1): 409-424. https://doi.org/10.1016/j.semarthrit.2021.02.002

Anandacoomarasamy A, Fransen M, March L. Obesity and the musculoskeletal system. Curr Opin Rheumatol 2009; 21(1): 71-77. https://doi.org/10.1097/BOR.0b013e3283202447

Oza MJ, Garud MS, Gaikwad AB, Kulkarni YA. Fibromyalgia syndrome: role of obesity and nutrients. In: Nutrition and Functional Foods for Healthy Aging: Elsevier; 2017.

Favalli EG, Biggioggero M, Crotti C, Becciolini A, Raimondo MG, Meroni PL. Sex and management of rheumatoid arthritis. Clin Rev Allergy Immunol 2019; 56(3): 333-345.

https://doi.org/10.1007/s12016-018-8724-2

Jiao J, Vincent A, Cha SS, Luedtke CA, Oh TH. Relation of age with symptom severity and quality of life in patients with fibromyalgia. Mayo Clin Proc 2014; 89(2): 199-205.

https://doi.org/10.1016/j.mayocp.2013.09.027

Durmaz Y, Ilhanli I. Rheumatoid arthritis activity scores in patients with and without fibromyalgia syndrome. Arch Rheumatol 2021; 36(4): 429-435.

https://doi.org/10.46497/archrheumatol.2021.8425

Lage-Hansen PR, Chrysidis S, Lage-Hansen M, Hougaard A, Ejstrup L, Amris K. Concomitant fibromyalgia in rheumatoid arthritis is associated with the more frequent use of biological therapy: a cross-sectional study. Scand J Rheumatol 2016; 45(1): 45-48.

https://doi.org/10.3109/03009742.2015.1049605

Durán J, Combe B, Niu J, Rincheval N, Gaujoux-Viala C, Felson DT. The effect on treatment response of fibromyalgic symptoms in early rheumatoid arthritis patients: results from the ESPOIR cohort. Rheumatology 2015; 54(12): 2166-2170.

https://doi.org/10.1093/rheumatology/kev236

Jones GT, Mallawaarachchi B, Shim J, Lock J, Macfarlane GJ. The prevalence of fibromyalgia in axial spondyloarthritis. Rheumatology 2020; 40(10): 1581-1591.

https://doi.org/10.1093/rheumatology/kez690

Aloush V, Ablin JN, Reitblat T, Caspi D, Elkayam O. Fibromyalgia in women with ankylosing spondylitis. Rheumatol Int 2007; 27(9): 865-868.

https://doi.org/10.1007/s00296-007-0334-6

Demirdal S, Cakir T, Tugrul T, Subasi V. Coexisting of fibromyalgia syndrome and ankylosing spondylitis. Acta Medica Mediterr 2013; 29: 827-833.

Salaffi F, De Angelis R, Carotti M, Gutierrez M, Sarzi-Puttini P, Atzeni F. Fibromyalgia in patients with axial spondyloarthritis: epidemiological profile and effect on measures of disease activity. Rheumatol Int 2014; 34(8): 1103-1110.

https://doi.org/10.1007/s00296-014-2995-4

Brikman S, Furer V, Wollman J, Borok S, Matz H, Polachek A, et al. The effect of the presence of fibromyalgia on common clinical disease activity indices in patients with psoriatic arthritis: a cross-sectional study. Rheumatology 2016; 43(9): 1749-1754.

https://doi.org/10.1093/rheumatology/kew070

Duruöz MT, Gezer HH, Nas K, Kilic E, Sargin B, Acer Kasman S, et al. The impact of fatigue on patients with psoriatic arthritis: a multi-center study of the TLAR-network. Rheumatol Int 2020; 40(11): 1803-1815.

https://doi.org/10.1007/s00296-020-04576-0

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Published

31-10-2024

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Original Articles

How to Cite

1.
Hayat W, Khan S, Adnan S, Din ZU, Mustafa SH, Hussain I. Impact of Fibromyalgia on Disease activity in Inflammatory Arthritis: A Cohort Study Conducted at Tertiary Care Hospital of Peshawar, Pakistan. Pak Armed Forces Med J [Internet]. 2024 Oct. 31 [cited 2024 Dec. 3];74(5):1290-4. Available from: https://pafmj.org/PAFMJ/article/view/8935