The impact of fibromyalgia in disease activity assessment and treatment response in axial spondyloarthritis

Öz

Aim: Spondyloarthritis represents a group of diseases with common clinical features. When axial symptoms are predominant, the disease is called axial SpA (axSpA). Fibromyalgia frequently accompanies rheumatological diseases and affects the evaluation of disease activity measurements and treatment responses. In this study, we aimed to compare axSpA patients with and without accompanying fibromyalgia syndrome (FS). Material and Method: The patients with axSpA were retrospectively reviewed according to the Assessment of Spondyloarthritis international Society classification criteria. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate, and C-reactive protein data were used to evaluate disease activity. The Bath Ankylosing Spondylitis Functional Index (BASFI) was used to evaluate the functional status of the patients. Results: The study included a total of 300 patients, including 162 (54%) males and 138 (46%) females. The median age of the patients (25%-75% IQR) was 35 (30-46) years. In the comparison of the two axSpA groups with and without FS, age, BASFI, ESR and CRP levels, and the rate of receiving biological therapy were similar. In the FS group, female gender was dominant (n = 46, 92%; p = 0.000) and the rates of peripheral arthritis and BASDAI were significantly higher (p = 0.024 and p = 0.004, respectively). Conclusion: AxSpA is frequently accompanied by FS, especially in women. The symptoms of FS cause an increase in disease activity scores. Therefore, it is evaluated as low treatment response. The disease activity of FS and axSpA should be carefully evaluated to lower treatment costs and apply more accurate treatment.

Anahtar Kelimeler

• axial spondyloarthritis
• fibromyalgia
• disease activity
• treatment response

Aksiyal Spondiloartritte Fibromiyaljinin Hastalık Aktivitesi Değerlendirilmesine ve Tedavi Yanıtına Etkisi

Öz

Amaç: Spondiloartritler, ortak klinik özellikleri olan bir grup hastalığı temsil eder. Aksiyal semptomların baskın olduğu aksiyal SpA (axSpA) olarak tanımlanır. Fibromiyalji sıklıkla romatolojik hastalıklara eşlik eder ve hastalık aktivitesi ölçümleri ve tedavi yanıtlarının değerlendirilmesini etkiler. Bu çalışmada, axSpA'da eşlik eden fibromiyalji sendromu olan hastaları, axSpA hastaları ile karşılaştırmayı amaçladık. Gereç ve Yöntem: Aksiyel spondiloartritli hastalar, Assessment of Spondylo Artritis International Society sınıflandırma kriterlerine göre geriye dönük olarak incelendi. Bath AS Hastalık Aktivite Endeksi (BASDAI), eritrosit sedimantasyon hızı ve c-reaktif protein verileri hastalık aktivitesine erişmek için kullanıldı. Hastaların fonksiyonel durumlarını değerlendirmek için Bath AS Fonksiyonel İndeks (BASFI) kullanıldı. Bulgular: Çalışmaya 162 (% 54) erkek ve 138 (% 46) kadın olmak üzere toplam 300 hasta dahil edildi. Hastaların ortanca yaşı (25-75 IQR) 35 (30-46) idi. İki grubun karşılaştırılmasında: axSpA ve FM + axSpA; yaş, BASFI, ESR ve CRP seviyeleri ve biyolojik tedavi alan hastaların oranı benzerdi. AxSPA + FM grubunda kadın cinsiyet dominant 46 (% 92) (p = 0.000), periferik artrit ve BASDAI anlamlı olarak yüksekti (p = 0.024, p = 0.004). Sonuç: AxSpA'ya özellikle kadınlarda sıklıkla FM eşlik eder. FM semptomları hastalık aktivite skorlarında artışa neden olur. Bu nedenle düşük tedavi yanıtı olarak değerlendirilir. FM ve axSpA'nın hastalık aktiviteleri, daha düşük tedavi maliyetleri ve daha doğru tedavi için dikkatlice değerlendirilmelidir.

Anahtar Kelimeler

• aksiyel spondilartrit
• fibromyalji
• hastalık aktivitesi
• tedavi yanıtı

Kaynakça

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