Frequency of Fibromyalgianess in Patients With Rheumatoid Arhtritis and Ankylosing Spondylitis:A Multicenter Study of Turkish League Against Rheumatism (TLAR) Network

Objectives: This study was aimed to evaluate the frequency of fibromyalgianess, fibromyalgia syndrome (FS) and widespread pain in patients with Rheumatoid Arthritis (RA) and Ankylosing Spondylitis (AS) and their relationship with clinical and demographic parameters. Patients and Methods: This cross-sectional multicenter trial was performed in 14 centers across Türkiye. 661 patients (342 RA, 319 AS) have been recruited for the study. In these cohorts those who did not meet the criteria for FS and had widespread pain (widespread pain index≥7) were evaluated as a separate group. Clinical status and demographic parameters of patients in both cohorts were evaluated as well as the evaluations of RA and AS patients with widespread pain (widespread pain index≥7) and RA and AS patients with FS groups. In addition, correlations between Polysymptomatic Distress Scale (PSD) scores and visual analogue scale (VAS), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), Disease Activity Score using 28 joint counts (DAS 28) for RA patients and VAS, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS) for AS patients were analyzed. Results: Frequencies of patients with FS and patients who had PSD scores≥12 were 34.1% and 44.4% in all RA patients respectively. Moreover, FS and PSD scores ≥12 were found as 29.2% and 36.9% in all AS patients respectively. PSD scores of RA patients with FS were higher than all RA and RA with widespread pain patients’. SDAI and CDAI scores of RA patients with FSwere higher than all RA and RA with widespread pain patients’as well. Similarly,PSD scores of AS patients with FS were higher than all AS and AS with widespread pain patients’. ASDAS-ESR and BASDAI scores of AS patients with FS were found higher than all AS and AS with widespread pain patients’. Conclusion: Disease activity scores including pain in RA and AS patients’ were seemed higher in the presence of FS or fibromyalgianess. It may be related to clinical parameters, but cohort studies with long-term follow-up are needed in order to reveal causality. Additionally, in order to reduce overtreatment, coexistence of fibromyalgianess should be kept in mind in patients who had inflammatory diseases like RA and AS especially with intractable widespread pain.