Fibromyalgia Patients Who Meet the ACR 1990 Criteria Have More Severe Disease

Carmen E. Gota¹, Benjamin Nutter² and William Wilke³, ¹The Cleveland Clinic Rheum, The Cleveland Clinic Desk A50, Cleveland, OH, ²Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, ³Rheumatology & Immunology, Cleveland Clinic Foundation, Cleveland, OH

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Diagnostic criteria and fibromyalgia

Session Information

Title: Fibromyalgia and Soft Tissue Disorders

Session Type: Abstract Submissions (ACR)

Background/Purpose:

To compare the fibromyalgia patients who meet the 1990 ACR criteria for fibromyalgia with those who do not.

Methods:

All new consecutive patients diagnosed with fibromyalgia that were seen in the Rheumatology Department at the Cleveland Clinic by two physicians between September 1^st, 2008 and January 31^st, 2011, were enrolled in the study.

Enrollment in the study was based on clinician’s overall impression of patient suffering from fibromyalgia.

Three hundred and six patients were enrolled.

Data collected included: demographics, detailed fibromyalgia symptoms, physical examination findings (tender points, brisk deep-tendon reflexes and carotid artery tenderness on palpation), family history of fibromyalgia and mood disorders and comorbidities. All patients were asked to complete the following questionnaires: Brief Patient Health Questionnaire Mood Scale (PHQ -9), Epworth Sleepiness Scale (ESS), Mood Disorders Questionnaire (MDQ), Fibromyalgia impact questionnaire (FIQ), Symptom Intensity Scale (SIS) and Health Assessment Questionnaire Disability Index (HAQ-DI ).

Results:

We compared 240 fibromyalgia patients who met the ACR 1990 criteria with the other 66 patients who did not (lacked widespread pain or had <11 tender points). Patients who met the ACR 1990 criteria, compared to the rest of the patients, had higher depression scores, PHQ-9 12 (7.75, 16) vs 9.5 (5, 14.7), p<0.03; higher regional pain scores 12 (9, 15) vs 9 (6, 12), p<0.001; higher VAS fatigue 8 (7, 9) vs 7.25 (5, 9), p =0.022; higher symptom intensity score SIS 7 ( 6.21, 8.25) vs 6.25 (5.25, 6. 75), p <0.001; higher FIQ score 69.03 (65.1, 80.8) vs 59.95 (46.11, 72.74), p =0.001; higher difficulty with daily activities involving large muscle groups - FIQ-1 score 16 (7, 24) vs 12 (7, 20), p 0.039; less days when they felt well in the course of a week - FIQ-2 score 1(0, 2) vs 2 ( 0, 3) , p = 0.003.

Conclusion:

Fibromyalgia patients who meet the ACR 1990 criteria represent a more severe subset, manifested by more disability, and higher depression scores.

Disclosure:

C. E. Gota,
None;

B. Nutter,
None;

W. Wilke,
None.

« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/fibromyalgia-patients-who-meet-the-acr-1990-criteria-have-more-severe-disease/