From the Case Western Reserve University School of Medicine at MetroHealth Medical Center.
J Clin Rheumatol. 2021 Dec 1;27(8):e399-e403. doi: 10.1097/RHU.0000000000001490.
Fibromyalgia (FM) is common among patients with ankylosing spondylitis (AS), and its coexistence is believed to interfere with the measurement of patient-reported outcomes of disease activity and function in AS because of overlapping symptoms between the 2 diseases. This can confound clinical assessment and treatment decisions.
The aim of this study was to assess the relationship between the Fibromyalgia Symptom Scale (FSS) and its components, the Widespread Pain Index (WPI), and System Severity Scale with measures of disease activity, function, and patient-reported outcomes in AS.
We recruited 63 AS patients (aged ≥18 years) meeting the modified New York criteria, and Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score-C-Reactive Protein, Routine Assessment of Patient Index Data 3, and Bath Ankylosing Spondylitis Functional Index questionnaires were administered to them. The presence of FM was determined using validated 2010 American College of Rheumatology diagnostic criteria for FM.
Twenty-eight of 63 patients (44.4%) with AS and FM had higher disease activity and greater impairment of functional ability compared with AS patients without FM. Using multiple linear regression estimates, there was no significant relationship of FSS scores with Bath Ankylosing Spondylitis Disease Activity Index (p = 0.36), Routine Assessment of Patient Index Data 3 (p = 0.50), Ankylosing Spondylitis Disease Activity Score-C-Reactive Protein (p = 0.24), Bath Ankylosing Spondylitis Functional Index (p = 0.42) scores, or erythrocyte sedimentation rate (p = 0.82) and C-reactive protein (p = 0.75).
Despite a high prevalence of FM in our patients with the diagnosis of AS, there was no relationship between FSS and measures of disease activity or function in AS, suggesting that FSS and its components could be a useful tool to assess FM in AS patients. Also, FM impairs functional ability in patients with AS.
纤维肌痛（FM）在强直性脊柱炎（AS）患者中很常见，由于这两种疾病的症状重叠，其共存被认为会干扰 AS 患者疾病活动和功能的患者报告结局的测量，从而对临床评估和治疗决策产生影响。
本研究旨在评估纤维肌痛症状量表（FSS）及其组成部分、广泛疼痛指数（WPI）和系统严重程度量表与 AS 患者的疾病活动、功能和患者报告结局测量之间的关系。
我们招募了 63 名符合改良纽约标准的 AS 患者（年龄≥18 岁），并对他们进行了 Bath 强直性脊柱炎疾病活动指数、强直性脊柱炎疾病活动评分-C 反应蛋白、常规评估患者指数数据 3 和 Bath 强直性脊柱炎功能指数问卷调查。使用经过验证的 2010 年美国风湿病学会纤维肌痛诊断标准确定 FM 的存在。
63 名 AS 患者中有 28 名（44.4%）合并 FM，与无 FM 的 AS 患者相比，这些患者的疾病活动度更高，功能能力受损更严重。使用多元线性回归估计，FSS 评分与 Bath 强直性脊柱炎疾病活动指数（p = 0.36）、常规评估患者指数数据 3（p = 0.50）、强直性脊柱炎疾病活动评分-C 反应蛋白（p = 0.24）、Bath 强直性脊柱炎功能指数（p = 0.42）评分或红细胞沉降率（p = 0.82）和 C 反应蛋白（p = 0.75）均无显著相关性。
尽管我们的 AS 患者中有很高的 FM 患病率，但 FSS 与 AS 中的疾病活动或功能测量之间没有关系，这表明 FSS 及其组成部分可能是评估 AS 患者 FM 的有用工具。此外，FM 会损害 AS 患者的功能能力。
