Session Type: Abstract Submissions (ACR)
Fibromyalgia (FMS) is a chronic widespread pain condition that may be associated with inflammatory chronic disorders like rheumatoid arthritis (RA) and systemic sclerosis (SSc). In these latter, it is important to detect associated FMS since it may interfere with disease specific assessment. Moreover, in some studies, associated FMS could be related with the occurence of Secondary Sjogren’s Syndrome (SSS). FMS diagnosis is frequently established by clinical analysis, although there are newly validated screening tools (Fibromyalgia Rapid Screening Tool (FiRST)) and diagnostic criteria (ACR 2010 criteria) that may confirm clinical impression.
The aims of the study was i) to estimate the incidence rate of FMS in RA and SSc, ii) to compare these rates according to clinical diagnosis, screening tool (FiRST), diagnostic criteria (ACR 1990 and 2010), iii) to test if FMS was associated with the occurrence of SSS.
Consecutive adult patients with confirmed RA or SSc (international classification criteria), visiting 4 university hospitals were included. Demographic characteristics were collected and FMS diagnosis was established by several consecutive methods: (i) FMS clinical impression, (ii) FMS screening by FiRST questionnaire, (iii) FMS diagnosis by ACR 1990 classification criteria and ACR 2010 diagnostic criteria. Cohen’s Kappa correlation coefficient (K) was calculated for inter-agreement between diagnostic tools.
In total, 274 patients were recruited: FMS was diagnosed (ACR2010) in 22.4% of the cases, without significant difference between RA and SSc (p=0.11). In global and each group, FMS occurrence was not associated with a SSS.
-In the RA group, 172 patients (12.2 % men, 54.4 ± 15.11 years old) were recruited.
FMS clinical diagnosis was proposed in 32.5%, detected by the FiRST in 22.6%, confirmed with ACR 1990 criteria in 22.1% and with ACR 2010 criteria in 19.1% of the RA patients.
In RA, considering ACR 2010 criteria as the current gold standard, K was: 0.66 with clinical diagnosis, 0.47 with FiRST and 0.41 with ACR 1990 classification criteria.
-In the SSc group, 122 patients (13.9% men, 58.2 ± 12.1 years old) were recruited: 54 with limited SSc and 66 with diffuse SSc. Clinical diagnosis of FMS was proposed in 39.3%, detected by the FiRST in 27.9%, confirmed with ACR 1990 criteria in 30.3% and with ACR 2010 criteria in 27.0% of the SSc patients.
In SSc, considering ACR 2010 criteria as the gold standard, K was 0.64 with clinical diagnosis, 0.63 with FiRST questionnaire, 0.50 with ACR 1990 classification criteria.
Our results reveal an unknown high prevalence of SSc associated FMS, which will need to be taken into account in the assessment of the patients who often report a heavy burden of pain. Both in SSc and RA, occurrence of FMS is not related to SSS. In both groups, there was a good correlation between FiRST and ACR FMS 2010 criteria. FiRST may represent a simple method to detect FMS in various rheumatological conditions. Further studies are needed to analyze FMS association with specific RA and SSc phenotypes.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/incidence-of-fibromyalgia-syndrome-in-systemic-sclerosis-and-rheumatoid-arthritis-comparative-results-according-to-clinical-diagnosis-screening-test-with-fibromyalgia-rapid-screening-tool-diagnosis/