Background/Purpose: One area not assessed by studies to evaluate the efficacy of new medications in patients with inflammatory arthritis is whether the patient may have concomitant fibromyalgia.  This may well impact response to treatment.  We evaluated whether patients who have inflammatory arthritis and failed various biologic therapies were  more likely to also have fibromyalgia.

Methods: Patients taking biologics were evaluated in a rheumatology office practice.  We determined patients whether they responded or failed various biologic therapies. Diagnoses included rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and lupus.

Results: 219 patients in a rheumatology office practice taking biologic response modifiers were divided into those with inflammatory arthritis (RA/PsA/AS/SLE) who were thought to have concomitant fibromyalgia (36pts, 16.4%) and those with only inflammatory arthritis but without fibromyalgia (183pts, 83.5%).

Of the patients with inflammatory arthritis or lupus with concomitant fibromyalgia, those who failed 2 or more biologics was 15, (41.7%). Patients with inflammatory arthritis or lupus but without concomitant fibromyalgia who failed 2 or more biologics was 41 pts (22.4%).

Conclusion: Patients who failed biological therapies often had concomitant fibromyalgia.  This may be a significant factor in the lack of efficacy of these drugs.  Whereas they may control the symptoms of inflammatory disease and patients get partial satisfaction, the fact that they want to try other biologic therapy may be due, in part, to the presence of concomitant fibromyalgia.  This should be assessed in future studies to evaluate new medications for patients with inflammatory joint disease.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/patients-who-fail-biologics-are-more-likely-to-have-concomitant-fibromyalgia/