Spondyloarthritis and fibromyalgia: interfering association or differential diagnosis?

Wendling, Daniel; Prati, Clément

doi:10.1007/s10067-016-3353-3

Cited by 10 publications

(10 citation statements)

References 19 publications

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“…Patients with many positive enthesitis sites may be more likely to present with concomitant fibromyalgia, and the clinical overlap of these conditions may be more frequent in women than in men with axSpA [ 31 , 32 ]. AxSpA patients with concomitant fibromyalgia could be expected to respond less efficiently to TNFi.…”

Section: Discussionmentioning

confidence: 99%

Site-specific resolution of enthesitis in patients with axial spondyloarthritis treated with tumor necrosis factor inhibitors

et al. 2021

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Background Enthesitis is a hallmark of spondyloarthritis (SpA) with a substantial impact on quality of life. Reports of treatment effectiveness across individual enthesitis sites in real-world patients with axial SpA (axSpA) are limited. We investigated the evolution of enthesitis following tumor necrosis factor inhibitor (TNFi) initiation in axSpA patients, both cumulatively and at specific axial and peripheral sites. Methods AxSpA patients in the Swiss Clinical Quality Management Registry were included if they initiated a TNFi, had an available Maastricht Ankylosing Spondylitis Enthesitis Score, modified to include the plantar fascia (mMASES, 0–15), at start of treatment and after 6 and/or 12 months and ≥12 months follow-up. Logistic regression models were utilized to analyze explanatory variables for enthesitis resolution. Results Overall, 1668 TNFi treatment courses (TCs) were included, of which 1117 (67%) had active enthesitis at baseline. Reduction in mMASES at the 6- and 12-month timepoints was experienced in 72% and 70% of TCs, respectively. Enthesitis resolution at 6/12 months occurred in 37.9%/43.0% of all TNFi TCs and 40.7%/50.9% of first TNFi TCs. At 6 months, a significant reduction in the frequency of enthesitis was observed at all sites, except for the Achilles tendon and plantar fascia among first TNFi TCs, while at 12 months, reduction was significant at all sites in both TC groups. Enthesitis resolved in 60.3–77% across anatomical sites, while new incident enthesitis occurred in 4.0–13.5% of all TNFi TCs at 12 months. Both baseline and new-incident enthesitis occurred most frequently at the posterior superior iliac spine and the fifth lumbar spinous process. Younger age and lower mMASES at baseline were predictors of complete enthesitis resolution, while female sex and second- or later-line TNFi treatment were associated with persistence of enthesitis at 12 months. Conclusion In real-world axSpA patients treated with a TNFi, enthesitis improved in the majority of patients across all anatomical sites. Significant improvement at the Achilles and plantar fascia entheses was observed only at 12 months. Complete and site-specific enthesitis resolution occurred in ≥40% and ≥60% of TCs evaluated at 12 months, with a low incidence of new site-specific enthesitis. Trial registration Not applicable.

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Section: Discussionmentioning

confidence: 99%

Site-specific resolution of enthesitis in patients with axial spondyloarthritis treated with tumor necrosis factor inhibitors

et al. 2021

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“…Patients with many positive enthesitis sites may be more likely to present with concomitant bromyalgia, and the clinical overlap of these conditions may be more frequent in women than in men with axSpA. [31,32] AxSpA patients with concomitant bromyalgia could be expected to respond less e ciently to TNFi.…”

Section: Discussionmentioning

confidence: 99%

Site-Specific Resolution of Enthesitis in Patients With Axial Spondyloarthritis Treated With Tumor Necrosis Factor Inhibitors

Nissén¹,

Möller

Ciurea

et al. 2020

Preprint

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Background: Enthesitis is a hallmark of spondyloarthritis (SpA) with substantial impact on quality of life. Reports of treatment effectiveness across individual enthesitis sites in real-world patients with axial SpA (axSpA) are limited. We investigated the evolution of enthesitis following tumour necrosis factor inhibitor (TNFi) initiation in axSpA patients, cumulatively and at specific axial and peripheral sites.Methods: AxSpA patients in the Swiss Clinical Quality Management Registry were included if they initiated a TNFi, had an available Maastricht Ankylosing Spondylitis Enthesitis Score, modified to include the plantar fascia (mMASES, 0–15), at start of treatment and after 6 and/or 12 months and ≥12 months follow-up. Logistic regression models were utilized to analyze explanatory variables for enthesitis resolution. Results: Overall, 1668 TNFi treatment courses (TCs) were included, of which 1117 (67%) had active enthesitis at baseline. Reduction in mMASES at the 6- and 12-month time points was experienced in 72% and 70% of TCs, respectively. Enthesitis resolution at 6/12 months occurred in 37.9% and 43.0% of all TNFi TCs and 40.7% and 50.9% of first TNFi TCs. At 6 months, a significant reduction in the frequency of enthesitis was observed at all sites, except for the Achilles tendon and plantar fascia among first TNFi TCs while at 12 months, reduction was significant at all sites in both TC groups. Enthesitis resolved in 60.3%–77% across anatomical sites, while new incident enthesitis occurred in 4.0%–13.5% of all TNFi TCs at 12 months. Both baseline and new-incident enthesitis occurred most frequently at the posterior superior iliac spine and the fifth lumbar spinous process. Younger age and lower mMASES at baseline were predictors of complete enthesitis resolution, while female sex and second- or later-line TNFi treatment were associated with persistence of enthesitis at 12 months. Conclusion: In real-world axSpA patients treated with a TNFi, enthesitis improved in the majority of patients across all anatomical sites. Significant improvement at the Achilles and plantar fascia entheses was observed only at 12 months. Complete and site-specific enthesitis resolution occurred in ≥40% and ≥60% of TCs evaluated at 12 months, with a low incidence of new site-specific enthesitis.Trial registration: not applicable

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“…An editorial reviewed the similarities between SpA and FMS, which included overlap of disease activity measures, found in patients with presumed enthesitis [41]. They asserted that FMS tender points (TPs) were anatomically located near or at enthesitis sites, which was confirmed in a separate study [8].…”

Section: The Spondyloarthropathies (Spa)mentioning

confidence: 95%

Recognize Comorbid Fibromyalgia Syndrome in Order to Better Evaluate Selected Rheumatic Diseases

Wilke¹

2018

Discussions of Unusual Topics in Fibromyalgia

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The prevalence of comorbid fibromyalgia syndrome in autoimmune rheumatic diseases is clinically significantly higher than is fibromyalgia syndrome in the general population. By increasing pain sensitivity and fatigue, it disproportionately inflates subjective signs and symptoms, thereby obfuscating composite indices used to measure biological disease activity, the degree of disability, and the quality of life. By modifying primary disease phenotype, it also interferes with diagnostic precision. This review documents its effects on rheumatoid arthritis, the spondyloarthropathies, and systemic lupus erythematosus; and offers a general remedial strategy.

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Spondyloarthritis and fibromyalgia: interfering association or differential diagnosis?

Cited by 10 publications

References 19 publications

Site-specific resolution of enthesitis in patients with axial spondyloarthritis treated with tumor necrosis factor inhibitors

Site-specific resolution of enthesitis in patients with axial spondyloarthritis treated with tumor necrosis factor inhibitors

Site-Specific Resolution of Enthesitis in Patients With Axial Spondyloarthritis Treated With Tumor Necrosis Factor Inhibitors

Recognize Comorbid Fibromyalgia Syndrome in Order to Better Evaluate Selected Rheumatic Diseases

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