Prevalence and Impact of Rheumatologic Pain in Cystic Fibrosis Adult Patients

Abstract

BackgroundWith the improvement of cystic fibrosis (CF) patient survival, the prevalence of long-term complications increased, among them rheumatologic disorders.MethodsThe aim of this prospective study was to evaluate the prevalence of spinal and joint pain, and their impact on disability, anxiety, depression, and quality of life in CF adult patients.ResultsForty-seven patients were analyzed, 72% of men, mean aged 28 years, with a mean body mass index of 22 kg/m2 and a mean FEV1% of 63%. Twenty-two patients (47%) described rheumatologic pain either spinal (n = 15, 32%) and/or joint pain (n = 14, 30%). Patients with spinal and/or joint pain were shorter (p = 0.023), more frequently colonized with Staphylococcus aureus (p < 0.008), had more frequent ΔF508 homozygous mutations (p = 0.014), and a trend for more impairment of the 6-min walking distance (p = 0.050). The presence of rheumatologic pain tended to be associated with disability according to the Health Assessment Questionnaire (HAQ) and anxiety. Compared with patients with no pain patients with both spinal and joint pain exhibited a more pronounced impact on the St George's Respiratory Questionnaire (SGRQ).ConclusionRheumatologic pain is frequent in CF adult patients, and may affect daily living, anxiety and quality of life. Systematic assessment of rheumatologic pain should be included in the management of CF patients.

A grumbling concern: A survey of gastrointestinal symptoms in cystic fibrosis in the modulator era

“…This may reflect the findings of recently published studies in CF that GI symptom scores were found to be higher in female participants 4,13 . However, we do acknowledge that sex differences were not seen in all studies, with studies by Mainz et al finding no difference in GI symptoms based on sex 2,12 . The lower number of male participants prevented sub-analysis of the results by modulator status and gender and so conclusions around GI symptoms based on gender cannot be drawn in this survey.…”

“…Common gastrointestinal symptoms include abdominal pain, flatulence, bloating, and foul-smelling stools 2,3 , with over one in five pwCF reporting moderate to severe gastrointestinal symptoms 4 . Approximately 85% of pwCF are pancreatic insufficient necessitating the need for pancreatic enzyme replacement therapy (PERT) and between 2-5% each year will develop distal intestinal obstruction syndrome (DIOS) 5,6 .…”

Clinical relevance of low bone density in cystic fibrosis adult patients: A pilot study

“…[12] We recently showed a more important impairment on HAQ scale in patients with both spinal and joint pain. [4] CF quality of life is associated with several factors including FEV 1 %, BMI, pulmonary exacerbations, and depression and anxiety. [23,24] Several limitations of our study have to be highlighted.…”

“…Rheumatologic pain and arthritis were assessed using a questionnaire as previously described. [ 4 ] For this study, the question regarding spinal pain (“Did you have spinal pain?”) was considered.…”

Cystic fibrosis: comorbidity with other serious diseases

“…22 пациента (47%) описали ревматологическую боль либо в позвоночнике (n = 15,32%), либо в суставах (n = 14,30%). Пациенты с болями в позвоночнике и / или суставах были ниже ростом (р = 0,023), чаще колонизированы Staphylococcus aureus (р <0,008), чаще имели гомозиготные мутации ΔF508 (р = 0,014) [70]. В педиатрической практике группа ученых под руководством V. Comanici изучала распространенность артрита, связанного с МВ.…”