Fibromyalgia in patients with psoriatic arthritis: Relationship with enthesopathy, sleep, fatigue and quality of life

Abstract

Objectives To evaluate the relationship of fibromyalgia with enthesopathy, sleep, fatigue and quality of life in patients with psoriatic arthritis. Methods The psoriatic arthritis patients according to CASPAR criteria were included in the study. The diagnosis of fibromyalgia was based on 2016 ACR criteria. Demographic and clinical parameters were noted. Disease activity and enthesopathy were evaluated with Disease Activity Score‐28 (DAS‐28) and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), respectively. Functional assessment scales in this study were Psoriatic Arthritis Quality of Life (PsAQoL), Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF). Fibromyalgia Impact Questionnaire (FIQ) was used to assess the functional status of fibromyalgia. The Mann‐Whitney U test and Spearman correlation coefficient (ρ) were used. Hierarchical multiple regression analysis used to examine the differential contributions to FIQ score. P < .05 was accepted as significant. Results We enrolled 50 PsA patients (31 female, 19 male) with a mean age of 49.5 years (SD: 10.2) and mean disease duration 7.5 years (SD: 7.5). Thirty‐two patients (64% of PsA patients) fulfilled ACR criteria for fibromyalgia. The mean scores of MASES, PSQI, MAF and PsAQoL were significantly higher in patients with fibromyalgia (P < .05). The correlations between FIQ and other functional parameters were as follows; MASES (ρ = 0.71, P < .0005), PSQI (ρ = 0.62, P < .0005), MAF (ρ = 0.60, P < .0005), PsAQoL (ρ = 0.61, P < .0005). A moderate correlation was existing between FIQ and DAS‐28 (ρ = 0.42, P = .03). Conclusions Coexistence of fibromyalgia in PsA patients is associated with the presence of enthesopathy, poor quality of life, sleep disturbance and fatigue.

Fibromyalgia and psoriatic arthritis: Partners together

“…In this issue of the Journal 2 studies address this matter in patients with psoriatic arthritis (PsA), a condition which affects up to 1% of the population. [2][3][4] Alsawy et al identified fibromyalgia, using the 2016 modification of the 2010/11 American College of Rheumatology (ACR) criteria, 5 in 38.3% of 60 patients with PsA attending an outpatient department. 2 More PsA fibromyalgia patients were female, and more had symmetrical polyarthritis than those without fibromyalgia.…”

“…As these studies indicate, as FIQ scores increase so do the clinical and functional outcomes worsen. 3 In each of the above studies the diagnosis of fibromyalgia has been defined as either present of absent. However, fibromyalgia symptoms actually exist on a spectrum and many patients have sub-criteria symptoms that will influence their self-report of pain, fatigue, sleep and cognition.…”

“…Ulutatar et al, using the same criteria, 5 identified fibromyalgia in 64% of 50 consecutively assessed patients with PsA, also more common in females 3 . Those with fibromyalgia had significantly higher enthesopathy scores, FIQ scores, poorer sleep quality, greater fatigue, and lower quality of life.…”

“…Patients may be inappropriately treated with disease‐modifying drugs when in fact they need pain modulatory drugs and lifestyle advise. As these studies indicate, as FIQ scores increase so do the clinical and functional outcomes worsen 3 …”

“…In this issue of the Journal 2 studies address this matter in patients with psoriatic arthritis (PsA), a condition which affects up to 1% of the population 2‐4 …”