Disease Activity Composite Indices in Patients with Rheumatoid Arthritis and Concomitant Fibromyalgia: Table 1

Toms, Jan; Soukup, Tomáš; Bradna, P; Hrncír, Z

doi:10.3899/jrheum.090805

Cited by 15 publications

(15 citation statements)

References 8 publications

(3 reference statements)

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“…11 In this study, among RA patients FM diagnosis based on ACR criteria 1990 was established in 21.02% of patients, and it was more prevalent in female patients. This was previously reported by Toms et al 12 and Pollard et al 13 also found that 17% of rheumatoid arthritis patients met the ACR classification criteria for FM. However a lower frequency (13.4%) of FM among RA patients was reported by-Ranzolin et al 14 In the present study, patients with RA and FM were older and had longer disease duration than those patients without FM.…”

Section: Discussionsupporting

confidence: 79%

Fibromyalgia in Egyptian Rheumatoid Arthritis Patients and patients with Depression

El-Bazz

El-Tokhy

Attia

et al. 2014

Egypt J of Rheumatol & Clinical Immunol

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Background: Fibromyalgia (FM) is a chronic musculoskeletal disorder resulting in chronic widespread pain. Although it is currently believed to be the result of a central nervous system malfunction that increases pain transmission and perception. Patients with fibromyalgia frequently experience psychiatric problems. Objectives: Is to estimate the presence of fibromyalgia among Egyptian patients with rheumatoid arthritis (RA) and those with chronic depression. Patients and methods: This study was done on 277 patients; 176 patients with rheumatoid arthritis (group I), and 101 patients with chronic depression (group II). The patients were selected from Al-Zahraa University Hospital, Al-Azhar University. All patients were subjected to thorough clinical examination, laboratory investigation, calculation of disease activity score, modified Beck scale for depression. Results: Among RA patients FM diagnosis was established in 21.02% patients and 20.45% were females. Their mean age; 48.43 (±6.85) years that was significantly higher than RA patients only (29.48±8.59) years. Among (group II) patients, FM diagnosis was established in 40 (39.60%) female patients and 3(2.97%) male patients. Our results showed that depressive symptoms were more common in RA patients with fibromyalgia. DAS28 score was significantly higher in RA patients with FM mainly due to subjective component (number of tender joints and patient global assessment). Conclusion: Fibromyalgia may coexist with autoimmune inflammatory disorder like RA, commoner in older age, females and it worsens the disease activity. However, it is more common in patients with chronic depression.

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Section: Discussionsupporting

confidence: 79%

Fibromyalgia in Egyptian Rheumatoid Arthritis Patients and patients with Depression

El-Bazz

El-Tokhy

Attia

et al. 2014

Egypt J of Rheumatol & Clinical Immunol

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“…In RA, pain is the major determinant of patient global assessment of disease activity [ 22 ]. In subjects with increased central pain sensitisation this may lead to increased pain reports and overestimates of disease activity [ 4 , 8 ]. This would also in part explain the significant proportion of RA patients who do not respond to treatment with biologics, since these drugs target proinflammatory pathways [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is plausible that subgroups of RA patients experience alterations in their central pain modulation which then becomes a primary cause of pain, possibly outlasting the inflammatory activity. In this subgroup, central pain sensitisation may contribute significantly to high tender joint counts and self-reporting of pain, causing overestimation of disease activity [ 8 ]. In RA patients, concomitant fibromyalgia has been found to be around 13–17% [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Pain Sensitisation in Women with Active Rheumatoid Arthritis: A Comparative Cross-Sectional Study

et al. 2015

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Objectives. In some rheumatoid arthritis (RA) patients, joint pain persists without signs of inflammation. This indicates that central pain sensitisation may play a role in the generation of chronic pain in a subgroup of RA. Our aim was to assess the degree of peripheral and central pain sensitisation in women with active RA compared to healthy controls (HC). Methods. 38 women with active RA (DAS28 > 2.6) and 38 female HC were included in, and completed, the study. Exclusion criteria were polyneuropathy, pregnancy, and no Danish language. Cuff Pressure Algometry measurements were carried out on the dominant lower leg. Pain threshold, pain tolerance, and pain sensitivity during tonic painful stimulation were recorded. Results. Women with active RA had significantly lower pain threshold (p < 0.01) and pain tolerance (p < 0.01) than HC. The mean temporal summation- (TS-) index in RA patients was 0.98 (SEM: 0.09) and 0.71 (SEM: 0.04) in HC (p < 0.01). Conclusion. Patients with active RA showed decreased pressure-pain threshold compared to HC. In addition, temporal summation of pressure-pain was increased, indicating central pain sensitization, at least in some patients. Defining this subgroup of patients may be of importance when considering treatment strategies.

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“…Furthermore, patients with RA often suffer from pain, physical disability, fatigue [15] and symptoms of depression and anxiety due to significant comorbidities, which may influence the patient's perception of how the arthritis is doing [16]. Additionally, in RA patients with concomitant FM, the low threshold of pain sensitivity found in this disease may lead to overestimation of the PGA [17]. Social, cultural and ethnic factors [1820] as well as the clinical setting (clinical trial or daily clinical practice) may also play a role in the reporting of disease activity.…”

Section: Discussionmentioning

confidence: 99%

The provisional ACR/EULAR definition of remission in RA: a comment on the patient global assessment criterion

et al. 2012

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Disease Activity Composite Indices in Patients with Rheumatoid Arthritis and Concomitant Fibromyalgia: Table 1

Cited by 15 publications

References 8 publications

Fibromyalgia in Egyptian Rheumatoid Arthritis Patients and patients with Depression

Fibromyalgia in Egyptian Rheumatoid Arthritis Patients and patients with Depression

Pain Sensitisation in Women with Active Rheumatoid Arthritis: A Comparative Cross-Sectional Study

The provisional ACR/EULAR definition of remission in RA: a comment on the patient global assessment criterion

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