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Evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis
BACKGROUND: Fibromyalgia (FM) can coexist with Spondyloarthritis (SpA) leading to diagnostic and treatment dilemmas, especially in the presence of enthesitis. With this study we aimed to estimate the prevalence of FM in SpA and to compare the clinical/disease features and TNF inhibitors (TNFi) in pa...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748456/ https://www.ncbi.nlm.nih.gov/pubmed/26860612 http://dx.doi.org/10.1186/s13075-016-0943-z |
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author | Bello, Natalia Etcheto, Adrien Béal, Caroline Dougados, Maxime Moltó, Anna |
author_facet | Bello, Natalia Etcheto, Adrien Béal, Caroline Dougados, Maxime Moltó, Anna |
author_sort | Bello, Natalia |
collection | PubMed |
description | BACKGROUND: Fibromyalgia (FM) can coexist with Spondyloarthritis (SpA) leading to diagnostic and treatment dilemmas, especially in the presence of enthesitis. With this study we aimed to estimate the prevalence of FM in SpA and to compare the clinical/disease features and TNF inhibitors (TNFi) in patients with/without FM. METHOD: FM was defined by a score = > 5/6 of the Fibromyalgia Rapid Screening Tool (FiRST). SpA patients (according to the rheumatologist) and consecutively consulting in the day care hospital but also in the outpatient clinic at the rheumatology department of a tertiary care university hospital were included. Demographics, disease characteristics, activity and severity and TNFi treatment were compared in patients with and without FM; retention rate of the first TNFi and associated factors were explored (Kaplan Meier and Cox regression). RESULTS: Of the 196 enrolled SpA patients, 42 (21.4 %) were positively screened for FM. No statistically significant differences in the prevalence of FM were found with regard to the fulfillment of the ASAS criteria for peripheral/axial SpA, nor with regard to the fulfillment of the imaging vs. clinical arm of the ASAS criteria. However, patients with coexisting FM presented significantly with more enthesitis, higher disease activity (BASDAI and VAS) and poorer function scores (BASFI). No differences were found with regard to the initiation of TNFi treatment (79.0 % vs. 70.0 %, respectively), but the retention rate of the first TNFi after 2 years was shorter in the group of patients with FM (28.1 % (95 % CI 12.5-44.0) vs. 41.7 % (95 % CI 32.2-51.3), p = 0.01). CONCLUSION: This study confirms that coexistent FM in SpA might impact the patient-reported outcome indices for disease activity and function, and the retention rate of TNFi treatment. |
format | Online Article Text |
id | pubmed-4748456 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47484562016-02-11 Evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis Bello, Natalia Etcheto, Adrien Béal, Caroline Dougados, Maxime Moltó, Anna Arthritis Res Ther Research Article BACKGROUND: Fibromyalgia (FM) can coexist with Spondyloarthritis (SpA) leading to diagnostic and treatment dilemmas, especially in the presence of enthesitis. With this study we aimed to estimate the prevalence of FM in SpA and to compare the clinical/disease features and TNF inhibitors (TNFi) in patients with/without FM. METHOD: FM was defined by a score = > 5/6 of the Fibromyalgia Rapid Screening Tool (FiRST). SpA patients (according to the rheumatologist) and consecutively consulting in the day care hospital but also in the outpatient clinic at the rheumatology department of a tertiary care university hospital were included. Demographics, disease characteristics, activity and severity and TNFi treatment were compared in patients with and without FM; retention rate of the first TNFi and associated factors were explored (Kaplan Meier and Cox regression). RESULTS: Of the 196 enrolled SpA patients, 42 (21.4 %) were positively screened for FM. No statistically significant differences in the prevalence of FM were found with regard to the fulfillment of the ASAS criteria for peripheral/axial SpA, nor with regard to the fulfillment of the imaging vs. clinical arm of the ASAS criteria. However, patients with coexisting FM presented significantly with more enthesitis, higher disease activity (BASDAI and VAS) and poorer function scores (BASFI). No differences were found with regard to the initiation of TNFi treatment (79.0 % vs. 70.0 %, respectively), but the retention rate of the first TNFi after 2 years was shorter in the group of patients with FM (28.1 % (95 % CI 12.5-44.0) vs. 41.7 % (95 % CI 32.2-51.3), p = 0.01). CONCLUSION: This study confirms that coexistent FM in SpA might impact the patient-reported outcome indices for disease activity and function, and the retention rate of TNFi treatment. BioMed Central 2016-02-09 2016 /pmc/articles/PMC4748456/ /pubmed/26860612 http://dx.doi.org/10.1186/s13075-016-0943-z Text en © Bello et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Bello, Natalia Etcheto, Adrien Béal, Caroline Dougados, Maxime Moltó, Anna Evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis |
title | Evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis |
title_full | Evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis |
title_fullStr | Evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis |
title_full_unstemmed | Evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis |
title_short | Evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis |
title_sort | evaluation of the impact of fibromyalgia in disease activity and treatment effect in spondyloarthritis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748456/ https://www.ncbi.nlm.nih.gov/pubmed/26860612 http://dx.doi.org/10.1186/s13075-016-0943-z |
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