Title:Fibromyalgia in Spondyloarthritis: Prevalence and Effect on Disease
Activity and Treatment
Volume: 19
Issue: 2
Author(s): Saidane Olfa, Selma Bouden*, Meriam Sahli, Aicha Ben Tekaya, Leila Rouached, Tekaya Rawdha, Ines Mahmoud and Leila Abdelmoula
Affiliation:
- Department of Rheumatology, Hôspital Charles-Nicolle, Tunis, Tunisia
Keywords:
Fibromyalgia, spondyloarthritis, prevalence, disease activity, BASDAI, ASDAS, TNF alpha blockers treatment.
Abstract:
Background: Fibromyalgia may be associated to Spondyloarthritis with which it shares
some common symptoms such as sleep disorders, fatigue and diffuse pain, leading to diagnostic and
treatment dilemmas.
Objectives: We aimed to determine the prevalence of fibromyalgia in axial spondyloarthritis and to
determine how fibromyalgia might influence the assessments of disease activity and how it might
impact treatment.
Methods: An observational cross-sectional study was conducted. The study included 100 patients
with axial spondyloarthritis according to the Assessment of SpondyloArthritis international Society
criteria. Fibromyalgia was diagnosed based on the 2010 American College of Rheumatology criteria.
Demographics, disease characteristics, activity parameters and treatment were compared between
patients with and without fibromyalgia. Patients were recruited from the hospitalization unit
and the outpatient clinic of rheumatology.
Results: The mean age of patients was 44.65 ± 13.13 years, with a sex ratio equal to 2. The prevalence
of fibromyalgia was 20%. Fibromyalgia associated factors were advanced age and a late age
at the onset of axial spondyloarthritis. Disease activity parameters such as global pain VAS,
BASDAI, ASDAS-ESR, ASDAS-CRP, BASFI and BAS-G as well as MASES and BASMI were
significantly higher in the presence of FM. Doses of paracetamol were significantly higher among
FM+ patients. Also, treatment duration of the current anti-TNF alpha agent was significantly shorter
among FM+ patients.
Conclusion: Our study showed that fibromyalgia was associated with axial spondyloarthritis in
20% of patients. Its presence was associated with higher disease activity parameters and negative
impact on the treatment.