ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1523

The Effect Size of Fibromyalgia on PG-VAS in Rheumatoid Arthritis Patients. Adjustment Proposal in DAS28-ESR

Luis I Lozano-Plata1, David Vega-Morales2, Ana Arana-Guajardo3, Mario Alberto Garza-Elizondo4, Cassandra Skinner-Taylor4, Roberto Negrete-López1, Jorge Esquivel-Valerio5 and Miguel A Villarreal-Alarcón6, 1Servicio de Reumatología, Departamento de Medicina Interna. Hospital Universitario “Dr. José Eleuterio González”. Universidad Autónoma de Nuevo León, Monterrey, Mexico, 2Universidad Autónoma de Nuevo Léon, Monterrey, Mexico, 3Servicio de Reumatología, Departamento de Medicina Interna del Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico, 4Servicio de Reumatología, Departamento de Medicina Interna del Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico, 5Rheumatology, Hospital Universitario, UANL., Monterrey, Mexico, 6Servicio de Reumatología, Departamento de Medicina Interna del Hospital Universitario “Dr. Jose Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords:

Session Information

Date: Monday, November 14, 2016

Title: Rheumatoid Arthritis – Clinical Aspects - Poster II: Co-morbidities and Complications

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

The disease activity score (DAS) is a method used to monitor disease activity in Rheumatoid Arthritis (RA). Diseases that cause chronic pain or mood disorders have been previously studied to assess their effect on the activity of RA. The aim of the study was to assess clinic, activity, and function characteristics on the DAS28-ESR in RA patients.

Methods:

This is an observational, descriptive cross-sectional study fron march 2013 to march 2014. We included patients with RA according to 2010 ACR/EULAR classification criteria. We analyzed the effect of Fibromyalgia, Knee Osteoarthritis knee, presence of Tendinopathy (any) on the status of RA activity. Evaluation of Health Assessment Questionnaire (HAQ) and Patient Global Visual Analogue Scale (PG-VAS) were included. We considered a VAS> 40 with clinical significance. All patients underwent joint count and ESR.

Results:

We analyzed 395 patients, 360 (91.1%) women , with mean age of 51.1 (SD 12.7). Table 1 shows the clinical and activity characteristics of the patients. We found in the bivariate analysis that the presence of a PG-VAS >40 was associated with a DAS28-ESR greater than 2.6 (OR: 12.47, 5.2-29 95% CI, p = 0.001). Fibromyalgia was a predictor of PG-VAS >40 (OR 3.49, 1.72-7.08 95% CI, p = 0.0001). The rest of the variables analyzed did not influence.

Conclusion:

We observed a negative effect of Fibromyalgia in the PG-VAS and therefore in the DAS28-ESR in patients with RA. The effect size of diagnostic Fibromyalgia on the DAS28 was 27%. We propose to adjust the DAS28, when the PG-VAS is above 40, by multiplying by 0.73, to consider the effect of Fibromyalgia in the evaluation.

Table 1. Clinic, activity, and function characteristics of RA patients

Variables

With FM

n= 39

Without FM

n= 356

p

Age, years mean, SD

55.5, 6.8

50.6, 13.3

0.02

DAS28-ESR median, IQR

3.01, 1.3

3.1, 1.4

0.5

ESR mm/Hr median, IQR

27.02, 14.8

29.1, 12

0.35

PG-VAS mm, mean , SD

29.9, 4.7

22, 1.2

0.001

PG-VAS > 40mm n,%

15, 38.5

54, 15.2

0.001

Presence of morning stiffness n,%

17, 43.6

119, 33.4

0.2

Presence of night pain n,%

39,100

336, 94.4

0.3

Functional class I n,%

32, 82.1

270, 75.8

0.14

Knee Osteoarthritis n,%

11, 28.2

61, 17.1

0.08

Tendinopathy n,%

4, 10.3

15, 4.2

0.094

HAQ-8

– Dress yourself, including tying shoelaces and doing buttons? n,%

29, 74.4

217, 61

0.1

– Get in and out of bed? n,%

36, 92.3

337, 94.7

0.5

– Lift a full cup or glass to your mouth? n,%

36, 92.3

317, 89

0.5

– Wash and dry your entire body? n,%

36, 92.3

336, 94.4

0.5

– Bend down to pick up clothing from the floor? n,%

34, 87.2

326, 91.6

0.35

– Turn faucets/taps on and off? n,%

38, 97.4

342, 96.1

0.67

– Get in and out of a car? n,%

36, 92.3

342, 96.1

0.27

– Walk outdoors on flat ground?

34, 87.2

320, 89.9

0.5

DAS28-ESR: Disease Activity Score of 28 joints with ESR, PG-VAS: Patient Global visual analogue scale, ESR: erythrocyte sedimentation rate, IQR: interquartile range, HAQ: Health Assessment Questionnaire. Functional class I:Without limitation to activities of daily living

Disclosure: L. I. Lozano-Plata, None; D. Vega-Morales, None; A. Arana-Guajardo, None; M. A. Garza-Elizondo, None; C. Skinner-Taylor, None; R. Negrete-López, None; J. Esquivel-Valerio, None; M. A. Villarreal-Alarcón, None.

To cite this abstract in AMA style:

Lozano-Plata LI, Vega-Morales D, Arana-Guajardo A, Garza-Elizondo MA, Skinner-Taylor C, Negrete-López R, Esquivel-Valerio J, Villarreal-Alarcón MA. The Effect Size of Fibromyalgia on PG-VAS in Rheumatoid Arthritis Patients. Adjustment Proposal in DAS28-ESR [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/the-effect-size-of-fibromyalgia-on-pg-vas-in-rheumatoid-arthritis-patients-adjustment-proposal-in-das28-esr/. Accessed .

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