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The influence of fibromyalgia on achieving remission in patients with long-standing rheumatoid arthritis

  • Observational Research
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Abstract

To investigate the influence of fibromyalgia (FM) on achieving remission defined on the basis of the Simplified Disease Activity Index (SDAI) remission criteria in patients with long-standing rheumatoid arthritis (RA). This observational longitudinal cohort consisted of long-standing RA patients being treated with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) or biological DMARDs (bDMARDs). After 6 months of follow-up, the patients fulfilling or not fulfilling the remission criteria were identified and compared with each other in terms of the presence of FM, neuropathic pain, and other comorbidities. At the end of the 6-month observation period, 24 of the 117 patients (20.4%) met the SDAI remission criteria. Logistic regression analysis showed that the modified Rheumatic Disease Comorbidity Index (mRDCI) (p = 0.0001), the FM presence (p = 0.0001), and the 36-item short-form health survey Mental Component Summary (SF-36 MCS) Score (p = 0.0088) were the strongest predictors of not being in SDAI remission. None of the patients with concomitant FM (17.1%) achieved SDAI remission. In comparison with the non-FM patients, the patients with RA and FM patients had worse scores on the SF-36 MCS (p = 0.011), on the sleep Visual Analogue Scale (VAS) (p = 0.018), on the self-counts of tender joints (p = 0.039), and on the PainDetect Questionnaire (PDQ) (p = 0.001). To avoid over treatment, an assessment of FM should be considered in RA patients who do not fulfil the remission criteria.

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Authors and Affiliations

  1. Rheumatology Department, Università Politecnica delle Marche, c/o Ospedale “Carlo Urbani”, Via Aldo Moro 25, 60035, Jesi, AN, Italy

    Fausto Salaffi, Antonella Draghessi & Marco Di Carlo

  2. Rheumatology Unit, ASST Fatebenefratelli-L. Sacco University Hospital, Milan, Italy

    Maria Chiara Gerardi, Fabiola Atzeni, Alberto Batticciotto, Rossella Talotta & Piercarlo Sarzi-Puttini

Authors
  1. Fausto Salaffi
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  2. Maria Chiara Gerardi
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  3. Fabiola Atzeni
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  4. Alberto Batticciotto
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  5. Rossella Talotta
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  6. Antonella Draghessi
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  7. Marco Di Carlo
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  8. Piercarlo Sarzi-Puttini
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Correspondence to Fausto Salaffi.

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All the authors declare that they have not received any financial support or other benefits from commercial sources for the work described in this paper. They also declare that they have no other financial interests that could create a potential conflict of interest or the appearance of a conflict of interest with regard to this work.

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All the procedures in this work were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Salaffi, F., Gerardi, M.C., Atzeni, F. et al. The influence of fibromyalgia on achieving remission in patients with long-standing rheumatoid arthritis. Rheumatol Int 37, 2035–2042 (2017). https://doi.org/10.1007/s00296-017-3792-4

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  • DOI: https://doi.org/10.1007/s00296-017-3792-4

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