The Effect on Treatment Response of Fibromyalgic Symptoms in Early Rheumatoid Arthritis Patients: Results from the ESPOIR Cohort

Overview

Journal Rheumatology (Oxford)

Publisher Oxford University Press

Specialty Rheumatology

Date 2015 Jul 16

PMID 26175470

Citations 13

Authors

Josefina Duran

Bernard Combe

Jingbo Niu

Nathalie Rincheval

Cecile Gaujoux-Viala

David T Felson

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate whether patients with RA who belong to the spectrum of fibromyalgic RA (FRA) have an impaired response to treatment measured by traditional activity scores.

Methods: Patients from the ESPOIR cohort were analysed. This prospective cohort included 813 patients with early arthritis not initially receiving DMARDs. Among the 697 patients who met RA classification criteria, we studied two groups, one with and the other without FRA. The following endpoints were compared at 6, 12 and 18 months using a mixed linear regression model: 28-joint DAS (DAS28), Simple Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI) and HAQ. In addition, attainment of low disease activity (LDA; DAS28 <3.2) and remission (DAS28 <2.6, SDAI <3.3, CDAI <2.8) at these time points was analysed.

Results: Patients with FRA (n = 120) had higher DAS28, SDAI, CDAI and HAQ scores than patients with RA and no fibromyalgic characteristics (n = 548). DAS28 and other DASs started out higher in subjects with FRA, and while they improved to a similar extent to in the isolated RA group, they remained consistently higher among FRA patients. Achievement of LDA and remission was significantly less likely in subjects with FRA.

Conclusion: Patients with FRA and RA will have a similar response to treatment according to the decrease in indexes of disease activity, but may miss the target of remission or LDA.

Citing Articles

The problem of residual pain in the assessment of rheumatoid arthritis activity.

Motyl G, Krupka W, Maslinska M Reumatologia. 2024; 62(3):176-186.

PMID: 39055728 PMC: 11267660. DOI: 10.5114/reum/189779.

Predicting Disease Activity in Rheumatoid Arthritis With the Fibromyalgia Survey Questionnaire: Does the Severity of Fibromyalgia Symptoms Matter?.

Gorzewski A, Heisler A, Neogi T, Muhammad L, Song J, Dunlop D J Rheumatol. 2022; 50(5):684-689.

PMID: 36521924 PMC: 10159881. DOI: 10.3899/jrheum.220507.

Disproportionate articular pain is a frequent phenomenon in rheumatoid arthritis and responds to treatment with sarilumab.

Choy E, Bykerk V, Lee Y, van Hoogstraten H, Ford K, Praestgaard A Rheumatology (Oxford). 2022; 62(7):2386-2393.

PMID: 36413080 PMC: 10321097. DOI: 10.1093/rheumatology/keac659.

Rheumatoid arthritis activity scores in patients with and without fibromyalgia syndrome.

Durmaz Y, Ilhanli I Ann Saudi Med. 2021; 41(4):246-252.

PMID: 34420399 PMC: 8380282. DOI: 10.5144/0256-4947.2021.246.

Beyond Rheumatoid Arthritis Evaluation: What are We Missing?.

Espinoza G, Maldonado G, Narvaez J, Guerrero R, Citera G, Rios C Open Access Rheumatol. 2021; 13:45-55.

PMID: 33790666 PMC: 8007602. DOI: 10.2147/OARRR.S298393.

References

Pollard L, Kingsley G, Choy E, Scott D . Fibromyalgic rheumatoid arthritis and disease assessment. Rheumatology (Oxford). 2010; 49(5):924-8. DOI: 10.1093/rheumatology/kep458. View

Ma M, Scott I, Kingsley G, Scott D . Remission in early rheumatoid arthritis. J Rheumatol. 2010; 37(7):1444-53. DOI: 10.3899/jrheum.091131. View

Naranjo A, Ojeda S, Francisco F, Erausquin C, Rua-Figueroa I, Rodriguez-Lozano C . Fibromyalgia in patients with rheumatoid arthritis is associated with higher scores of disability. Ann Rheum Dis. 2002; 61(7):660-1. PMC: 1754142. DOI: 10.1136/ard.61.7.660. View

Verstappen S, Bijlsma J, Verkleij H, Buskens E, Blaauw A, ter Borg E . Overview of work disability in rheumatoid arthritis patients as observed in cross-sectional and longitudinal surveys. Arthritis Rheum. 2004; 51(3):488-97. DOI: 10.1002/art.20419. View

Wolfe F, Cathey M, Kleinheksel S . Fibrositis (Fibromyalgia) in rheumatoid arthritis. J Rheumatol. 1984; 11(6):814-8. View

Wolfe F, Smythe H, Yunus M, Bennett R, Bombardier C, Goldenberg D . The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990; 33(2):160-72. DOI: 10.1002/art.1780330203. View

Wolfe F, Ross K, Anderson J, Russell I, Hebert L . The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995; 38(1):19-28. DOI: 10.1002/art.1780380104. View

Leeb B, Andel I, Sautner J, Nothnagl T, Rintelen B . The DAS28 in rheumatoid arthritis and fibromyalgia patients. Rheumatology (Oxford). 2004; 43(12):1504-7. DOI: 10.1093/rheumatology/keh322. View

Allaire S, Wolfe F, Niu J, LaValley M . Contemporary prevalence and incidence of work disability associated with rheumatoid arthritis in the US. Arthritis Rheum. 2008; 59(4):474-80. PMC: 3641514. DOI: 10.1002/art.23538. View

10.

Rintelen B, Haindl P, Maktari A, Nothnagl T, Hartl E, Leeb B . SDAI/CDAI levels in rheumatoid arthritis patients are highly dependent on patient's pain perception and gender. Scand J Rheumatol. 2008; 37(6):410-3. DOI: 10.1080/03009740802241717. View

11.

Coury F, Rossat A, Tebib A, Letroublon M, Gagnard A, Fantino B . Rheumatoid arthritis and fibromyalgia: a frequent unrelated association complicating disease management. J Rheumatol. 2009; 36(1):58-62. DOI: 10.3899/jrheum.080366. View

12.

Ranzolin A, Tavares Brenol J, Bredemeier M, Guarienti J, Rizzatti M, Feldman D . Association of concomitant fibromyalgia with worse disease activity score in 28 joints, health assessment questionnaire, and short form 36 scores in patients with rheumatoid arthritis. Arthritis Rheum. 2009; 61(6):794-800. DOI: 10.1002/art.24430. View

13.

Toms J, Soukup T, Bradna P, Hrncir Z . Disease activity composite indices in patients with rheumatoid arthritis and concomitant fibromyalgia. J Rheumatol. 2010; 37(2):468. DOI: 10.3899/jrheum.090805. View

14.

Schoels M, Knevel R, Aletaha D, Bijlsma J, Breedveld F, Boumpas D . Evidence for treating rheumatoid arthritis to target: results of a systematic literature search. Ann Rheum Dis. 2010; 69(4):638-643. PMC: 3015093. DOI: 10.1136/ard.2009.123976. View

15.

Katchamart W, Johnson S, Lin H, Phumethum V, Salliot C, Bombardier C . Predictors for remission in rheumatoid arthritis patients: A systematic review. Arthritis Care Res (Hoboken). 2010; 62(8):1128-43. DOI: 10.1002/acr.20188. View

16.

McWilliams D, Zhang W, Mansell J, Kiely P, Young A, Walsh D . Predictors of change in bodily pain in early rheumatoid arthritis: an inception cohort study. Arthritis Care Res (Hoboken). 2012; 64(10):1505-13. PMC: 3770924. DOI: 10.1002/acr.21723. View

17.

Andersson M, Svensson B, Bergman S . Chronic widespread pain in patients with rheumatoid arthritis and the relation between pain and disease activity measures over the first 5 years. J Rheumatol. 2013; 40(12):1977-85. DOI: 10.3899/jrheum.130493. View

18.

Cagnie B, Coppieters I, Denecker S, Six J, Danneels L, Meeus M . Central sensitization in fibromyalgia? A systematic review on structural and functional brain MRI. Semin Arthritis Rheum. 2014; 44(1):68-75. DOI: 10.1016/j.semarthrit.2014.01.001. View

19.

Wolfe F, Michaud K, Busch R, Katz R, Rasker J, Shahouri S . Polysymptomatic distress in patients with rheumatoid arthritis: understanding disproportionate response and its spectrum. Arthritis Care Res (Hoboken). 2014; 66(10):1465-71. DOI: 10.1002/acr.22300. View