Session Information
Session Type: Poster Session (Sunday)
Session Time: 9:00AM-11:00AM
Background/Purpose: The SELENA-SLEDAI is a tool for measuring the activity of systemic lupus. It is frequently used in clinical drug trials, but what is the value of this index in patients with lupus and concomitant fibromyalgia?
Methods: Patients were given an office questionnaire in which many of the SELENA-SLEDAI symptoms were listed.
Results: The fibromyalgia syndrome and non-fibromyalgia syndrome rheumatic disease groups did not significantly differ in age or education. In the fibromyalgia syndrome group, there were 191 patients (160 females and 31 males). In the control non-fibromyalgia syndrome rheumatic disease group, there were 130 patients (82 females and 48 males). The mean age for the fibromyalgia patients was 5
Analyzing the fibromyalgia syndrome sample, the SELENA-SLEDAI results were “arthritis” 119 patients (62.3%): cognitive changes 102 patients (53.5%); severe persistent headaches 74 patients (39.7%); hair loss 76 patients (39.8%); oral or nasal ulcers 46 patients (24.1%); facial numbness 106 patients (55.4%); chest pain with deep breathing 47 patients (24.7%); colitis 26 patients (13.6%); rash 66 patients (34.6%).
Conclusion: Patients with fibromyalgia frequently report symptoms that are part of the SELENA-SLEDAI disease activity scale. Therefore, patients with concomitant fibromyalgia and lupus may report these symptoms more commonly, and they may appear to be more resistant to treatment.
This has an important impact on clinical drug trials because the inclusion of patients with lupus and fibromyalgia together can lead to an apparent lack of efficacy for a new drug. In an evaluation of lupus patients by Wolfe, et al in 2014, of those given a diagnosis of lupus by a rheumatologist, 31% also met the criteria for fibromyalgia, based on the 2010 ACR criteria for the diagnosis.
New lupus treatments may appear to be ineffective, when actually they could be quite valuable if concomitant fibromyalgia is excluded. Using the SELENA-SLEDAI as an instrument for assessing lupus disease activity may be confounded by patients also having concomitant fibromyalgia.
To cite this abstract in AMA style:
Katz R, Polyak Wokurka J, Small B. The SELENA SLEDAI Is an Imperfect Measure of Lupus Disease Activity in Patients with Concomitant Fibromyalgia [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/the-selena-sledai-is-an-imperfect-measure-of-lupus-disease-activity-in-patients-with-concomitant-fibromyalgia/. Accessed .« Back to ACR/ARP Annual Meeting 2019
ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-selena-sledai-is-an-imperfect-measure-of-lupus-disease-activity-in-patients-with-concomitant-fibromyalgia/