ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 159

The Use of “Fibromyalgia Rapid Screening Tool” for Detection of Fibromyalgia in Patients with Chronic Arthritis Treated with Full and Tapered Biological Disease-Modifying Antirheumatic Drugs

Larissa Valor1, Diana Hernández-Flórez2, Tamara del Río2, Juan Gabriel Ovalles-Bonilla3, Julia Martínez-Barrio4, Iustina Janta5, Belen Serrano6, Claudia Saez5, Roberto Gonzalez5, Juan Carlos Nieto5, Carlos M Gonzalez5, Indalecio Monteagudo5 and Francisco Javier López Longo7, 1Rheumatology, Hospital general Universitario Gregorio Marañón, Madrid, Spain, 2Rheumatology, Gregorio Marañón University General Hospital, Madrid, Spain, 3Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain, 4Servicio de Reumatologia, Hospital General Universitario Gregorio Marañón, Madrid, Spain, 5Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain, 6Rheumatology, Hospital General Universitario Gregorio Marañón, Genoa, Italy, 7Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: ,

Session Information

Date: Sunday, November 5, 2017

Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes Poster I

Session Type: ACR Poster Session A

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

Background/Purpose: The coexistence of fibromyalgia (FM) and chronic arthritis is a challenge for an accurate identification of signs and symptoms associated with rheumatoid arthritis (RA), psoriatic arthritis (PsA), peripheral (PerSpA) and axial spondyloarthropathies (AxSpA). The Fibromyalgia Rapid Screening Tool (FiRST) is a validated questionnaire with high sensitivity and moderate specificity to identify 89% of FM cases, even when it is accompanied by anxiety, depression or functional disability. The use of full or tapered biological disease-modifying antirheumatic drugs (bDMARD) depends in many cases on the reliability of clinical indices which can be altered by the subjectivity of the patient and/or concomitant pathologies. Objective: To evaluate the prevalence of FM using the FiRST questionnaire in patients diagnosed with chronic arthritis and treated with bDMARD.

Methods: This cross-sectional study included 325 patients [178 (54,8%) females and 147 (45,2%) males] diagnosed of chronic arthritis and treated with bDMARDs. They were consecutively recruited in the Biological Therapy Unit from January to March 2015, all patients were in full or tapered bDMARD for at least 1 year. The dosage tapering had been made in patients with a maintained remission according to their rheumatologist attendant and the patient approval. All patients self-completed the FiRST questionnaire and a score> 5/6 was considered positive. The clinical assessment was always performed by the same investigator. Demographic, clinical and laboratory variables were collected and clinical indices related to each pathology were calculated (DAS28-ESR, DAS28-CRP, SDAI, CDAI, BASDAI, BASFI, ASDAS-CRP). Patients were classified as peripheral arthritis (PerAR: RA, PsA, PerSpA) and axial spondyloarthropathies (AxSpA).

Results:

A total of 68/325 (21%) patients had a FiRST>5/6. The time since diagnosis and the number of previous used bDMARD were not significant respect to FiRST<5/6. In the PerRA vs. AxSpA group we observed that 19% (n=43) and 35% (n=25) had FiRST>5/6, respectively (p=NS). Fifteen % of patients with tapered bDMARD had FiRST>5/6 vs. 85% of patients in full bDMARD dosage (p=0.001). Patients in clinical remission were higher in the PerAR group with tapered bDMARD dosage according to DAS28-ESR, SDAI and CDAI [(96%, 94% and 94%) (p=0.01, p=0.04, p=0.032), respectively]. In the PerAR subgroups, we found an association between tapered bDMARD and remission only in patients with RA according to DAS28-VSG, SDAI and CDAI (p=0.026, p=0.04, p=0.043, respectively). In the AxSpA group with tapered bDMARD dosage 86% of patients were in clinical remission according to BASDAI (p=0.019).

Conclusion: There was no difference between PerAR and AxSpA groups regarding FiRST>5/6. Patients with tapered bDMARD dosage had a lower proportion of FiRST>5/6, therefore early detection of patients with FiRST>5/6 might help us to better understand clinical activity in chronic arthritis and to improve diagnostic and therapeutic approaches of FM in these patients treated with bDMARD in terms of its efficacy and cost-effectiveness.

Disclosure: L. Valor, Roche, Novartis, Celgene, Janssen; Sanofi, 8; D. Hernández-Flórez, None; T. del Río, None; J. G. Ovalles-Bonilla, Pfizer, Roche, BMS, Asacpharma, Nordic Pharma, 8,Sanofi-Aventis Pharmaceutical, 5; J. Martínez-Barrio, None; I. Janta, None; B. Serrano, None; C. Saez, None; R. Gonzalez, None; J. C. Nieto, None; C. M. Gonzalez, MSD, Celgene, Novartis, Abbvie, Janssen, 5,MSD, Celgene, Novartis, Janssen, UCB Pharma, 8; I. Monteagudo, None; F. J. López Longo, None.

To cite this abstract in AMA style:

Valor L, Hernández-Flórez D, del Río T, Ovalles-Bonilla JG, Martínez-Barrio J, Janta I, Serrano B, Saez C, Gonzalez R, Nieto JC, Gonzalez CM, Monteagudo I, López Longo FJ. The Use of “Fibromyalgia Rapid Screening Tool” for Detection of Fibromyalgia in Patients with Chronic Arthritis Treated with Full and Tapered Biological Disease-Modifying Antirheumatic Drugs [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/the-use-of-fibromyalgia-rapid-screening-tool-for-detection-of-fibromyalgia-in-patients-with-chronic-arthritis-treated-with-full-and-tapered-biological-disease-modifying-antirheumatic-drugs/. Accessed .

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