In patients with axial spondyloarthritis (axSpA), high levels of axSpA disease activity and the presence of widespread pain were associated with the development of fibromyalgia (FM).
Patients with low levels of axSpA disease activity and widespread pain and those initiating a tumour necrosis factor (TNF) inhibitor were more likely to recover from FM.
Why this matters
Findings suggest that patients with a history of severe axSpA disease activity and widespread pain should be evaluated for the presence of comorbid FM.
The British Society of Rheumatology Biologics Register for Ankylosing Spondylitis (BSRBR-AS) is a prospective cohort study of 801 patients with axSpA.
FM was diagnosed using the self-reported Fibromyalgia Survey Diagnostic Criteria (FSDC) from 2015.
Disease activity and widespread pain were measured using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Widespread Pain Index (WPI).
Funding: British Society for Rheumatology.
Of 801 patients with axSpA:
686 were not diagnosed with FM at baseline, of whom 45 were diagnosed at the first follow-up.
115 were diagnosed with FM at baseline, of whom 77 had recovered from FM at the first follow-up.
A high baseline BASDAI (adjusted OR [aOR], 1.27; 95% CI, 1.08-1.49) and WPI (aOR, 1.14; 95% CI, 1.02-1.28; P<.05 for both) scores were significantly associated with the development of FM.
A low baseline BASFI (aOR, 0.68; 95% CI, 0.53-0.86) and WPI (aOR, 0.84; 95% CI, 0.72-0.97) scores and initiating a TNF inhibitor (aOR, 3.86; 95% CI, 1.54-9.71; P<.05 for all) were significantly associated with FM recovery.
Neither the 2016 FSDC nor the Assessment of SpondyloArthritis international Society classification criteria were ‘gold standard’ instruments with a high level of specificity.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.
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Cite this: Pavankumar Kamat. Axial Spondyloarthritis: Factors Associated with Fibromyalgia Development and Recovery - Medscape - Jun 07, 2021.