The co-occurrence and characteristics of patients with axial spondyloarthritis who meet criteria for fibromyalgia: results from a UK national register (BSRBR-AS)

Macfarlane, G. J., Barnish, M. S., Pathan, E., Martin, K. R., Haywood, K. L., Siebert, S. , Packham, J., Atzeni, F. and Jones, G. T. (2017) The co-occurrence and characteristics of patients with axial spondyloarthritis who meet criteria for fibromyalgia: results from a UK national register (BSRBR-AS). Arthritis and Rheumatology, 69(11), pp. 2144-2150. (doi: 10.1002/art.40185) (PMID:28622461)

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Abstract

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:MacFarlane, Gary and Siebert, Professor Stefan
Authors: Macfarlane, G. J., Barnish, M. S., Pathan, E., Martin, K. R., Haywood, K. L., Siebert, S., Packham, J., Atzeni, F., and Jones, G. T.
College/School:College of Medical Veterinary and Life Sciences > School of Infection & Immunity
Journal Name:Arthritis and Rheumatology
Publisher:Wiley
ISSN:0004-3591
ISSN (Online):2326-5205
Published Online:16 June 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in Arthritis and Rheumatology 69(11): 2144-2150
Publisher Policy:Reproduced under a Creative Commons License

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