Background/Purpose: Takayasu’s arteritis (TAK) is a large-vessel vasculitis of the aorta and its major branches. To our knowledge, no data is reported about the frequency of Fibromyalgia Syndrome (FM), in TAK. We aimed to investigate the frequency of FM in TAK, defined according to the new 2010 ACR Preliminary Diagnostic Criteria for Fibromyalgia. The correlation between ACR-1990 and 2010 FM criterias and the effect of patient-reported outcomes (PROs) such as Health Assessment Questionnaire (HAQ), Multidimensional Assessment of Fatigue Scale (MAF), Short-Form 36-item survey (SF–36) and hospital anxiety and depression scales (HADS) on FM were analyzed.

Methods: We studied 51 patients with TAK (F/M: 47/4, mean age: 42.3 years),  50  (F/M: 35/15, mean age: 40.89 years) healthy controls (HC). All patients were examined for FM tender points by two observers (kappa: 0.648) and asked to complete new ACR 2010 FM questionnaire for FM (ref1). SF–36, MAF and HADS were used to assess quality of life together with HAQ. Seventeen patients were re-evaluated 6 months later.

Results: Six(11,7%) patients with TAK and 5 HC (10%) met the ACR-2010 FM criteria, whereas only 3(5,8%) TAK patients and no controls (0%) met the 1990 Criteria. No significant differences regarding the FM frequency were present according to both ACR-2010 and 1990 FM criterias between TAK and HC. No differences were also observed for the 2 subscales of 2010 criteria, the Widespread Pain Index(WPI) and the Symptom Severity scale(SSS) scale among the groups. Fourteen patients (33,3%) were clinically active. FM presence was also similar between active and inactive patients (p=0,188). The results of PROs were showed in Table 1. WPI correlate significantly with tender points (r=0,477, p<0,001), MAF (r=0,623, p<0,001), HAQ (r=0,477, p<0,001), anxiety (r=0,458, p<0,001), depression (r=0,378, p<0,001), PCS (r=-0,586, p<0,001) and MCS (r=-0, 335, p<0,001). SSS correlate significantly with tender points (r=0,477, p<0,001), MAF (r=0,775, p<0,001), HAQ (r=0,437, p<0,001), anxiety (r=0,557, p<0,001), depression (r=0,438, p<0,001),  PCS (r= -0,593, p<0,001) and MCS (r=-0,531, p<0,001). During follow-up, no significant differences between baseline and 6.month were observed in terms of  frequency of FM, MAF, HAQ,HADS, PCS and MCS.

Table 1:  Results of the patient-reported outcomes in TAK and controls

	Takayasu’s  arteritis (n=51)	Healthy controls (n=50)	P values
MAF	18,5 (0-49,7)	17,5 (0-38,6)	0,282
Anxiety scale score	5 (0-21)	5 (0-18)	0,533
Depression scale score	3 (0-21)	3 (0-14	0,529
HAQ	0,15 (0- 2,35)	0 (0-0,8)	<0,001
PCS	46,9 (17,5-61,7)	53,4 (30,4-100)	0,003
MCS	46 (22,4-65,4)	49,9 (20,8-100)	0,350

Conclusion: The frequency of FM is similar to general population in patients with Takayasu arteritis.  However, although other PROs also does not differ from HC, the new FM criteria subscales WPI and SSS significantly correlated with scales such as SF-36, MAF, anxiety and depression scale and HAQ in TA, suggesting that in a minority of patients with FM and TA, PROs are affected with FM presence.

1. Wolfe F, Clauw DJ, Fitzcharles MA, et all. The ACR preliminary diagnostic criteria forfibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010 May;62(5):600-10.

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