Philip J Mease1. 1. Rheumatology Clinical Research, Swedish Medical Center; University of Washington School of Medicine, Seattle, Washington, USA.
Abstract
PURPOSE OF REVIEW: Fibromyalgia is a clinical representation of the neurobiological phenomenon of central sensitization, characterized by chronic widespread pain, fatigue, sleep disturbance, and other symptoms. Fibromyalgia may occur in conjunction with chronic rheumatic diseases, driven by the effects of chronic pain and inflammation and likely influenced by the patient's genetic and psychoemotional background. This article reviews the data on prevalence of concomitant fibromyalgia and its impact on disease assessment in patients with spondyloarthritis (SpA) and psoriatic arthritis (PsA). RECENT FINDINGS: Fibromyalgia occurs in 2-8% of the general population. In AxSpA cohorts the prevalence has been reported in 4-25%, and in PsA, 16-22%, the majority being female. Measures of disease activity which are comprised partly or wholly of patient-reported outcomes such as pain and patient global are significantly higher in patients with concomitant fibromyalgia and do not improve as much with treatment as more objective measures, a finding which has been observed in other diseases such as rheumatoid arthritis and lupus. SUMMARY: Fibromyalgia occurs in a significant proportion of patients with SpA and PsA. Disease activity measures with subjective elements are conflated in patients with fibromyalgia and do not reliably assess true inflammatory disease. This needs to be taken into account when evaluating the impact of immunomodulatory therapy.
PURPOSE OF REVIEW: Fibromyalgia is a clinical representation of the neurobiological phenomenon of central sensitization, characterized by chronic widespread pain, fatigue, sleep disturbance, and other symptoms. Fibromyalgia may occur in conjunction with chronic rheumatic diseases, driven by the effects of chronic pain and inflammation and likely influenced by the patient's genetic and psychoemotional background. This article reviews the data on prevalence of concomitant fibromyalgia and its impact on disease assessment in patients with spondyloarthritis (SpA) and psoriatic arthritis (PsA). RECENT FINDINGS:Fibromyalgia occurs in 2-8% of the general population. In AxSpA cohorts the prevalence has been reported in 4-25%, and in PsA, 16-22%, the majority being female. Measures of disease activity which are comprised partly or wholly of patient-reported outcomes such as pain and patient global are significantly higher in patients with concomitant fibromyalgia and do not improve as much with treatment as more objective measures, a finding which has been observed in other diseases such as rheumatoid arthritis and lupus. SUMMARY:Fibromyalgia occurs in a significant proportion of patients with SpA and PsA. Disease activity measures with subjective elements are conflated in patients with fibromyalgia and do not reliably assess true inflammatory disease. This needs to be taken into account when evaluating the impact of immunomodulatory therapy.
Authors: Michael J Nissen; Burkhard Möller; Adrian Ciurea; Ruediger B Mueller; Patrick Zueger; Martin Schulz; Fabiana Ganz; Almut Scherer; Eleftherios Papagiannoulis; Thomas Hügle Journal: Arthritis Res Ther Date: 2021-06-09 Impact factor: 5.156
Authors: Kevin L Winthrop; Michael E Weinblatt; Joan Bathon; Gerd R Burmester; Philip J Mease; Leslie Crofford; Vivian Bykerk; Maxime Dougados; James Todd Rosenbaum; Xavier Mariette; Joachim Sieper; Fritz Melchers; Bruce N Cronstein; Ferry C Breedveld; Joachim Kalden; Josef S Smolen; Daniel Furst Journal: Ann Rheum Dis Date: 2019-10-29 Impact factor: 19.103