Background/Purpose: To assess the clinical features and psychological status of the rheumatoid arthritis(RA) patients with fibromyalgia(FM) in a real-world observational setting.

Methods: Between December 2018 to April 2019, 202 patients with RA were enrolled from the inpatients in Rheumatology and Immunology Department in Peking University People’s Hospital. All the patients were evaluated whether incorporating FM translation using the 1990 ACR-FM classification criteria. Disease activity, functional and psychological status were accessed by Disease Activity Score in 28 joints (DAS-28), Short Form-36 survey (SF-36), Health Assessment Questionnaire(HAQ), Hospital Anxiety and Depression Scale (HADS) and 0-10 visual analogue scale (VAS).

Results: Among the 202 RA patients, 42(20.8%) were concomitant with FM. Compared to those patients without FM, RA patients with FM（RA-FM patients） had higher DAS-28 score (6.0 vs. 4.4, p=0.011) and much more 28-tender joint counts (TJC) (16.5 vs. 4.5, P< 0.001). RA-FM patients had worse HAQ (1.24 vs. 0.66, P< 0.001) and lower SF-36 (28.6 vs.58.2, P< 0.001). Fatigue is more common in RA-FM patients (88.1% vs. 50.6%，P< 0.001). RA-FM patients also had higher anxiety (10 vs. 4, P< 0.001) and depression scores (12 vs. 6, P< 0.001). ESR, CRP, morning stiffness time and 28-swollen joint counts (SJC) showed no difference between these two groups.

Conclusion: From these real world data，fibromyalgia is more common than generally regard in RA patients. RA patients with FM result in higher disease activity，worse functional and psychological status. RA patients with FM also have poorer quality of life. DAS-28 scores may be overestimated in RA patients with FM. In RA patient that does not reach remission, the possibility of fibromyalgia should be considered.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-and-psychological-assessment-of-rheumatoid-arthritis-patients-with-fibromyalgia-a-real-world-study/