Effects of fibromyalgia on the disease activity and treatment of patients with axial spondyloarthritis

OBJECTIVES: To investigate whether patients with radiologically positive spondyloarthritis (SpA), suffer from comorbid fibromyalgia (FM), and to explore the impact of FM on the clinical manifestations and blood test results of patients with ankylosing spondylitis (AS). METHODS: 121 patients with spondyloarthritis (SpA) were enrolled in the study. The body function of the patients was evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI); the mental health was evaluated using the Hospital Anxiety and Depression Scale (HADS). RESULTS: Out of 121 patients with SpA, 111 patients were with axial spondyloarthritis (axSpA) and 11 patients with FM; 10 patients with peripheral SpA and 1 patient with FM. In axSpA, 107 were radiologically positive axSpA patients, 11 were complicated by FM, and 4 were radiologically negative axSpA (nr-axSpA). Among radiologically positive axSpA, the proportion of female patients in the FM group was higher (63.6%, P<0.05). The ASDAS-C-reactive protein (CRP), ASDAS-erythrocyte sedimentation rate (ESR), BASDAI, BASFI, and HADS-anxiety score, and HADS-depression score of the FM group were all significantly higher than those of the non-FM group. CONCLUSIONS: When determining the treatment plan for SpA, the possibility of coexistence of FM should be considered, and adjuvant treatment should be given when necessary.