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Abstract Number: 1229

Frequency of Fibromyalgia Using Validated Measures in a Sample of Patients with Psoriatic Arthritis and Impact on Disease: A Cross-Sectional Multinational Study

avin maroof1, Nelly Ziade2, Lina El Kibbi3, Bassel Elzorkany4, Nizar Ani5, ASAL ADNAN RIDHA6, Faiq Gorial7, NABAA IHSAN JAWAD AWADH8, Nada Al Chama9, Chafika Haouichat10, Fatima Alnaimat11, Suad Mohamed Abdulla Hannawi12, Suad Hannawi13, Saed Atawnah14, HUSSEIN HALABI15, Manal Al-Mashaleh16, Ahmed Abogamal17, Rachid Bahiri18, Sahar Saad19, maha sabkar20, Krystel Aouad21, Laure Gossec22, Ihsane Hmamouchi23, nabaa abbas24, Elyes Bouajina25, Laila Aljazye26 and Laila ayoub27, and ArLAR-ARCH group, 1University of Kurdistan Hawler, Erbil, Iraq, 2Saint-Joseph University, Beirut, Lebanon, 3Division of rheumatology / Department of Medicine / Specialized Medical Center, Riyadh, Saudi Arabia, 4Private (BZRC), Cairo, Egypt, 5Baghdad College of Medicine, Baghdad, Iraq, 6Baghdad Teaching Hospital, baghdad, Iraq, 7Rheumatology Unit/Department of Medicine/ College of Medicine/ University of Baghdad, Baghdad, Iraq, 8Baghdad Teaching Hospital / Medical City, Baghdad, Iraq, 9Rheumatology Department / Ebn Al Nafiss Hospital / Damascus, Damascus, Syria, 10Djillali Bounaama university hospital, Algiers, Algeria, 11The University of Jordan, amman, Jordan, 12Rheymatology Department / Emirate Health Services / Dubai, Dubai, United Arab Emirates, 13Ministry of Health and Prevention, Dubai, United Arab Emirates, 14Al-Quds University / Alahli Hospital / Hebron ,Palestine, Hebron, Palestinian Territories, 15King Faisal Specialist Hospital / Jeddah, Jeddah, Saudi Arabia, 16Royal Medical Services, Amman, Jordan, 17Dr. Sliman Al Habib Hospital / Al-Azhar Faculty of Medicine, Dubai, United Arab Emirates, 18El Ayachi Hospital / Medical University Hospital / Rabat, Rabat, Morocco, 19King Hamad University Hospital / Assiut Medical School of Egypt, Al Sayh, Bahrain, 20King Hamad university Hospital, Arad, Bahrain, 21Saint George Hospital University Medical Center, Beirut, Lebanon, 22Sorbonne Université, Paris, France, 23Rheumatology Unit, Lalla Aicha Temara Hospital, Temara, Rabat, Morocco, 24Baghdad teaching hospital, Medical city, Baghdad, Iraq, Baghdad, Iraq, 25Farhat Hached Hospital of Sousse, Tunisia, Sousse, Tunisia, 26Tripoli / Libya, Tripoli, Libya, 27Rheumatology unit, department of internal medicine, Tripoli Central Hospital. Faculty of Medicine, University of Tripoli, Libya, Tripoli, Libya

Meeting: ACR Convergence 2024

Keywords: Diagnostic criteria, fibromyalgia, Patient reported outcomes, Psoriatic arthritis, quality of life

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Session Information

Date: Sunday, November 17, 2024

Title: Pain in Rheumatic Disease Including Fibromyalgia Poster

Session Type: Poster Session B

Session Time: 10:30AM-12:30PM

Background/Purpose: Fibromyalgia (FM), a chronic pain disorder, is more prevalent in psoriatic arthritis (PsA) patients, impacting quality of life and potentially leading to unnecessary treatment escalation. Cultural factors may influence FM presentation in Arab countries, necessitating an understanding of its frequency and impact in this region for effective interventions. 

This study aims to determine FM frequency in Arab PsA patients using the FiRST questionnaire, identify associated factors, assess diagnostic agreement, and examine the impact of FM on patient-reported outcomes and disease activity, ultimately contributing to the development of culturally sensitive interventions.

Methods: Data from 554 PsA patients from the Arab League of Associations for Rheumatology (ArLAR) countries were analyzed. The primary outcome was the frequency of FM, determined using the Fibromyalgia Rapid Screening Tool (FiRST) questionnaire (score ≥6). Secondary outcomes included patient-reported outcomes (PROs) assessed using the Patient Health Questionnaire (PHQ),Health Assessment Questionnaire (HAQ), Physician Global Assessment (PhGA), Patient Global Assessment (PGA),Douleur Arthrite Psoriasis (DAPS), and Psoriatic Arthritis Impact of Disease (PsAID1) questionnaires. Independent predictors of a positive FiRST score were identified using logistic regression. The agreement between self-reported FM (FiRST) and physician-diagnosed FM (ACR 2010 criteria) was assessed using Cronbach’s Alpha. 

Results: Of the 536 patients (mean age 45.6 years, 40.9% male), 19.0% (n=102) screened positive for FM. Independent factors associated with a positive FiRST score included a higher BMI (Odds ratio [OR] 1.07, p=0.014), not having oligoarthritis (OR 0.38, p=0.011), dyslipidemia (OR 2.29, p=0.031), a lower ESR (OR 0.99, p=0.029), and worse DAPS (OR 1.05, p< 0.001) or PHQ (OR 1.45, < 0.001) scores. Patients with FM reported significantly (p< 0.001) worse outcomes on PsAID1, PHQ, HAQ, PhGA, PGA and DAPS (for those with a CRP available). Agreement between self-reported using the FiRST questionnaire and physician-diagnosed FM was moderate with Cronbach’s alpha average measures intraclass correlation of 0.588 (95% CI 0.508 to 0.655). However, the FiRST score demonstrated good discriminatory ability for physician-diagnosed FM (AUC 83.3%, 95%CI 79.3 to 87.3%) with a threshold value of 3 offered 80% sensitivity and specificity.

Conclusion: FM was prevalent in Arab PsA patients, with one in five having a diagnosis of FM using the FiRST score and was associated with worse disease activity and quality of life. Discrepancies in diagnosis highlight the need for standardized approaches, potentially incorporating validated screening tools like FiRST, and increased awareness of FM in this population.

Supporting image 1

Patient Reported Outcome Measures according to groups

Supporting image 2

Diagnosis of Fibromyalgia according to physician and the FIRST score (using 5 or more as the threshold value)

Supporting image 3

Logistic Regression Analysis of variables associated with Fibromyalgia


Disclosures: a. maroof: None; N. Ziade: AbbVie/Abbott, 1, 6, Celgene, 5, Eli Lilly, 5, 6, Gilead, 5, Janssen, 5, 6, Pfizer, 5, 6, Roche, 1, 6; L. El Kibbi: None; B. Elzorkany: None; N. Ani: None; A. RIDHA: None; F. Gorial: None; N. AWADH: None; N. Al Chama: None; C. Haouichat: None; F. Alnaimat: None; S. Hannawi: None; S. Hannawi: AbbVie, 2, 6, Amgen, 2, 6, AstraZeneca, 2, 6, Boehringer Ingelheim, 6, Eli Lilly, 2, 6, Janssen, 2, 6, New Bridge, 6, Novartis, 6; S. Atawnah: None; H. HALABI: None; M. Al-Mashaleh: None; A. Abogamal: None; R. Bahiri: None; S. Saad: None; m. sabkar: None; K. Aouad: None; L. Gossec: AbbVie, 2, 5, Amgen, 2, Biogen, 5, Bristol-Myers Squibb (BMS), 2, Celltrion, 2, Eli Lilly, 2, 5, Galapagos, 2, Janssen, 2, MSD, 2, Novartis, 2, 5, Pfizer, 2, Sandoz, 2, UCB, 2, 5; I. Hmamouchi: None; n. abbas: None; E. Bouajina: None; L. Aljazye: None; L. ayoub: None.

To cite this abstract in AMA style:

maroof a, Ziade N, El Kibbi L, Elzorkany B, Ani N, RIDHA A, Gorial F, AWADH N, Al Chama N, Haouichat C, Alnaimat F, Hannawi S, Hannawi S, Atawnah S, HALABI H, Al-Mashaleh M, Abogamal A, Bahiri R, Saad S, sabkar m, Aouad K, Gossec L, Hmamouchi I, abbas n, Bouajina E, Aljazye L, ayoub L. Frequency of Fibromyalgia Using Validated Measures in a Sample of Patients with Psoriatic Arthritis and Impact on Disease: A Cross-Sectional Multinational Study [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/frequency-of-fibromyalgia-using-validated-measures-in-a-sample-of-patients-with-psoriatic-arthritis-and-impact-on-disease-a-cross-sectional-multinational-study/. Accessed .
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