TY - JOUR
T1 - Fibromyalgia in patients with axial spondyloarthritis
T2 - Epidemiological profile and effect on measures of disease activity
AU - Salaffi, Fausto
AU - De Angelis, Rossella
AU - Carotti, Marina
AU - Gutierrez, Marwin
AU - Sarzi-Puttini, Piercarlo
AU - Atzeni, Fabiola
PY - 2014
Y1 - 2014
N2 - To determine the prevalence of fibromyalgia (FM) in patients with ankylosing spondylitis (AS) or psoriatic arthritis (PsA) characterized by axial involvement (axial-PsA), and to assess the discriminative ability of different versions of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and the Bath Ankylosing Spondylitis Activity Disease Activity Index (BASDAI) in measuring disease activity in three different cohorts of patients with axial spondyloarthritis (axial-SpA), FM, or both (axial-SpA + FM), this study was divided into two phases: (1) 402 patients with definite AS or axial-PsA were examined to diagnose FM and estimate its prevalence; and (2) 419 patients (111 with axial-SpA, 248 with FM, and 60 with aSpA + FM) were evaluated using the different versions of the ASDAS and BASDAI to assess the effect on disease activity. The overall prevalence of FM in the axial-SpA population was 14.9 %, significantly higher among women (p <0.0001); the estimated prevalence in AS was 12.7 % and in axial-PsA was 17.2 %. Although the BASDAI scores correlated with those of ASDAS-C-reactive protein (CRP) and ASDAS-erythrocyte sedimentation rate (ESR) (p <0.0001), only ASDAS had sufficient discriminatory ability to assess disease activity. The addition of only one marker of inflammation led to an adequate level of significance (ASDAS-CRP, p = 0.0018; ASDAS-ESR, p = 0.003). FM is common in axial-SpA and more prevalent in female patients. Our findings suggest that ASDAS is better than BASDAI in distinguishing patients with disease activity from those with functional impairment. The use of ASDAS may be very useful in clinical practice as it allows treating patients with the most appropriate therapy.
AB - To determine the prevalence of fibromyalgia (FM) in patients with ankylosing spondylitis (AS) or psoriatic arthritis (PsA) characterized by axial involvement (axial-PsA), and to assess the discriminative ability of different versions of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and the Bath Ankylosing Spondylitis Activity Disease Activity Index (BASDAI) in measuring disease activity in three different cohorts of patients with axial spondyloarthritis (axial-SpA), FM, or both (axial-SpA + FM), this study was divided into two phases: (1) 402 patients with definite AS or axial-PsA were examined to diagnose FM and estimate its prevalence; and (2) 419 patients (111 with axial-SpA, 248 with FM, and 60 with aSpA + FM) were evaluated using the different versions of the ASDAS and BASDAI to assess the effect on disease activity. The overall prevalence of FM in the axial-SpA population was 14.9 %, significantly higher among women (p <0.0001); the estimated prevalence in AS was 12.7 % and in axial-PsA was 17.2 %. Although the BASDAI scores correlated with those of ASDAS-C-reactive protein (CRP) and ASDAS-erythrocyte sedimentation rate (ESR) (p <0.0001), only ASDAS had sufficient discriminatory ability to assess disease activity. The addition of only one marker of inflammation led to an adequate level of significance (ASDAS-CRP, p = 0.0018; ASDAS-ESR, p = 0.003). FM is common in axial-SpA and more prevalent in female patients. Our findings suggest that ASDAS is better than BASDAI in distinguishing patients with disease activity from those with functional impairment. The use of ASDAS may be very useful in clinical practice as it allows treating patients with the most appropriate therapy.
KW - ASDAS
KW - BASDAI
KW - Disease activity
KW - Fibromyalgia
KW - Prevalence
KW - Spondyloarthritis
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U2 - 10.1007/s00296-014-2955-9
DO - 10.1007/s00296-014-2955-9
M3 - Article
C2 - 24509896
AN - SCOPUS:84904857117
VL - 34
SP - 1103
EP - 1110
JO - Rheumatology International
JF - Rheumatology International
SN - 0172-8172
IS - 8
ER -