Department of Physical Medicine, Rheumatology and Rehabilitation, Damietta Specialized Hospital, Damietta, Egypt.
Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Rheumatol Int. 2019 Oct;39(10):1703-1710. doi: 10.1007/s00296-019-04403-8. Epub 2019 Aug 3.
Fibromyalgia (FM) is a common comorbidity in rheumatoid arthritis (RA). Recently, there were several updates for the American College of Rheumatology (ACR) FM criteria. To assess the performance of the 2016 revised ACR FM criteria in patients with RA in comparison to 1990 criteria and to study the relation to composite disease measures. This study included 130 adult RA patients fulfilling the 2010 ACR/EULAR classification criteria for RA. Patients were evaluated according to 2016 and 1990 ACR criteria for FM. Kappa agreement between the two criteria was determined. Spearman's correlation between the polysymptomatic distress scale (PSD) and selected variables including disease activity score-28 with erythrocyte sedimentation rate (DAS-28 ESR), clinical disease activity index (CDAI), patient global assessment (PGA), and visual analogue scale (VAS) for pain was evaluated. Of the 130 RA patients, 52 patients (40%) satisfied the 2016 criteria and 40 (31.5%) the 1990 criteria. The Kappa agreement between the two criteria was 0.733. RA patients with FM had higher DAS28-ESR, CDAI, PGA, and VAS compared with those without FM. A significant positive correlation was found between the polysymptomatic Distress scale (PSD) and DAS28-ESR, CDAI, and PGA (r 0.481, 0.516, 0.511, respectively, P < 0.001). FM coexists in a substantial number of RA patients according to the 2016 revised criteria and associated with high composite disease activity measures. Therefore, assessment of FM should be considered in RA patients with persistently high disease activity.
纤维肌痛（FM）是类风湿关节炎（RA）的常见合并症。最近，美国风湿病学会（ACR）更新了 FM 标准。本研究旨在评估与 1990 年标准相比，2016 年修订的 ACR FM 标准在 RA 患者中的表现，并研究其与综合疾病指标的关系。这项研究纳入了 130 名符合 2010 年 ACR/EULAR 类风湿关节炎分类标准的成年 RA 患者。根据 2016 年和 1990 年 ACR 纤维肌痛标准对患者进行评估。确定了这两个标准之间的kappa 一致性。评估了多症状困扰量表（PSD）与包括红细胞沉降率（DAS-28 ESR）、临床疾病活动指数（CDAI）、患者整体评估（PGA）和疼痛视觉模拟量表（VAS）在内的选定变量之间的Spearman 相关性。在这 130 名 RA 患者中，52 名（40%）符合 2016 年标准，40 名（31.5%）符合 1990 年标准。这两个标准之间的 Kappa 一致性为 0.733。患有 FM 的 RA 患者的 DAS28-ESR、CDAI、PGA 和 VAS 均高于无 FM 的患者。多症状困扰量表（PSD）与 DAS28-ESR、CDAI 和 PGA 之间存在显著正相关（r 分别为 0.481、0.516 和 0.511，P < 0.001）。根据 2016 年修订的标准，大量 RA 患者同时存在 FM，且与高综合疾病活动指标相关。因此，对于持续存在高疾病活动的 RA 患者，应考虑评估 FM。
