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Patients with SpA-FM may have overestimated disease activity
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In patients with spondyloarthritis affected by concomitant fibromyalgia, researchers found disease activity as measured by the Bath Ankylosing Spondylitis Disease Activity Index may be overestimated.
Fibromyalgia (FM) may be associated with spondyloarthritis (SpA), as these illnesses share common symptoms, including pain, stiffness and fatigue, the researchers wrote. To assess how FM influences SpA assessment, investigators performed a single-center, cross-sectional study of 103 patients. Of these patients, 81 had axial SpA and 22 had peripheral SpA (pSpA). In addition, 18 patients had concomitant fibromyalgia (FM), of whom 12 had axial SpA and six had pSpA. The researchers measured disease activity by using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score/C-reactive protein (ASDAS-CRP).
They found BASDAI was higher in patients with fibromyalgia (median interquartile range, 4.2 vs. 2.2), while ASDAS-CRP was not significantly different (median interquartile range, 2.7 vs. 2) between the patient groups. However, median ASDAS-CRP corresponded with higher disease activity in patients with SpA or FM compared with patients without FM who had moderate activity.
The researchers concluded SpA disease activity as measured by BASDAI may be overestimated and this overestimation could lead to inappropriate treatment escalation.
“This concomitant FM should be considered as an important contextual factor that may account for inaccuracy in assessing disease activity in SpA, particularly pSpA,” the researchers wrote. They added, “When interpreting these indices, physicians should be aware of the presence of concomitant FM to avoid inappropriate escalation of anti-inflammatory treatment.” – by Will Offit
Disclosure: Healio.com/Rheumatology could not confirm relevant financial disclosures at the time of publication.
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