Co-Occurrence and Characteristics of Patients With Axial Spondyloarthritis Who Meet Criteria for Fibromyalgia: Results From a UK National Register

Gary J MacFarlane, Maxwell S Barnish, Ejaz Pathan, Kathryn R Martin, Kirstie L Haywood, Stefan Siebert, Jonathan Packham, Fabiola Atzeni, Gareth T Jones

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Objective: To estimate the proportion of patients with axial spondyloarthritis (axSpA) who meet criteria for fibromyalgia (FM) and to characterise such patients.
Methods: The British Society for Rheumatology Biologics Register of Ankylosing Spondylitis (BSRBR-AS) recruits two cohorts of patients who meet ASAS criteria for axSpA across 83 centres in the United Kingdom. Patients are either newly starting (biologic cohort) or naïve (non-biologic cohort) to biologic therapy and are followed prospectively. At recruitment and follow-up, clinical information and measurements are recorded, while patients complete the 2011 research criteria for FM, assessments of disease activity and impact.
Results: 1504 patients (68% male) were eligible for the current analysis of whom 311 (20.7%) met criteria for FM. Prevalence was similar among those who fulfilled modified New York (mNY) criteria (19.7%), and ASAS imaging but not mNY criteria (25.2%), but lower among those who only fulfilled ASAS clinical criteria (9.5%). Patients who met FM criteria reported significantly worse disease activity, function, global severity scores, quality of life and were more likely to have moderate/severe levels of mood disorder and clinically important fatigue. They reported work impairment around half the time. Meeting FM criteria was not related to elevated C-reactive protein, or most extra-spinal manifestations, but was associated with a higher likelihood of having received biologic therapy.
Conclusion: Developing management approaches that address the significant unmet needs of the 1 in 5 axSpA patients who meet criteria for FM should be a research priority.
Original languageEnglish
Pages (from-to)2144-2150
Number of pages7
JournalArthritis & Rheumatology
Issue number11
Early online date27 Oct 2017
Publication statusPublished - Nov 2017

Bibliographical note

The British Society for Rheumatology (BSR) Biologics Register in Ankylosing Spondylitis is funded by the BSR and they have receive funds for this from Pfizer, AbbVie and UCB. These companies receive advance copies of manuscripts and can provide comments but have no input into determining the topics for analysis, publication and no input into the work involved in this analysis. This analysis is part-funded by Arthritis Research UK (Grant No: 21378)


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