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Abstract Number: 401

Association of Anti-Thyroid Autoantibodies with Fibromyalgia in Rheumatoid Arthritis

Jowairiyya Ahmad1, Helena Blumen2, Claudene George3, Asha Shrestha4 and Clement Tagoe5, 1Geriatrics, Albert Einstein College of Medicine/Montefiore Medical Centre, Bronx, NY, 2Geriatrics, Albert Einstein College of Medicine, Bronx, NY, 3Geriatrics, Albert Einstein College of Medicine/Montefiore Medical centre, Bronx, NY, 4Rheumatology, Albert Einstein College of Medicine/Montefiore Medical Centre, Bronx, NY, 5Rheumatology, Albert Einsetin College of Medicine/Montefiore Medical Centre, Bronx, NY

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Autoimmunity, Chronic pain, fibromyalgia, rheumatoid arthritis (RA) and spine involvement

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Session Information

Session Title: Rheumatoid Arthritis - Clinical Aspects: Novel Biomarkers and Other Measurements of Disease Activity

Session Type: Abstract Submissions (ACR)

Background/Purpose

Autoimmune thyroiditis has been linked independently with fibromyalgia and chronic widespread pain. We studied how the presence of autoimmune thyroiditis affects the clinical presentation of rheumatoid arthritis with particular reference to chronic pain syndromes

Methods

We studied a cohort of 203 patients with a diagnosis of rheumatoid arthritis for whom the presence or absence of autoimmune thyroid antibodies was documented. The relationships between thyroid autoantibodies and the presence fibromyalgia and chronic widespread pain were examined. Logistic regression analyses were performed to determine the statistical significance of these associations.

Results

In our sample of 203 patients, we identified 34% of patients who tested positive for anti-thyroid peroxidase antibodies (anti-TPO).  Thirty five percent of patients tested positive for anti-thyroglobulin antibodies (anti-TG). Among the thyroid autoantibody-positive patients, 37 % had a diagnosis of fibromyalgia or chronic widespread pain. Additional patient variables considered included age, sex, body mass index (BMI) and the presence of comorbidities, including type II diabetes.

Logistic regression analyses (adjusted by age, sex, diabetes and BMI) indicated that anti-TPO positive patients were more likely to be diagnosed with fibromyalgia and report the presence of chronic widespread pain, with an odds ratio of 3.42, 95% CI (1.665-7.017), p <.001. The odds ratio between anti-TG and fibromyalgia was not significant, p >.05. Patients who were either anti-TPO or anti-TG positive were more likely to be diagnosed with fibromyalgia with an odds ratio of 2.70, CI (1.193-6.082), p<.05.

When adjusted for degenerative disc disease, patients who were either anti-TPO or anti-TG positive were more likely to be diagnosed with fibromyalgia with an odds ratio of 2.508, CI (1.094-5.749), p<.05. Similarly patients with anti-TPO were more likely to have fibromyalgia with an adjusted OR of 3.356, CI (1.608-7.003), p <.05.  

Conclusion

There is a strong positive association between the presence of anti-thyroid autoantibodies and hence autoimmune thyroiditis, with fibromyalgia syndrome and chronic widespread pain in patients with established rheumatoid arthritis


Disclosure:

J. Ahmad,
None;

H. Blumen,
None;

C. George,
None;

A. Shrestha,
None;

C. Tagoe,
None.

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