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Clinical and psychological assessment of patients with rheumatoid arthritis and fibromyalgia: a real-world study

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Abstract

Objectives

To assess the clinical features and functional and psychological status of patients with rheumatoid arthritis (RA) and those with fibromyalgia (FM) in a real-world setting.

Method

Between December 2018 and April 2019, 202 inpatients with RA were enrolled from the Rheumatology and Immunology Department at Peking University People’s Hospital and assessed for the presence of FM using the 1990 American College of Rheumatology’s classification criteria for FM. Disease activity and functional and psychological status were assessed using the Disease Activity Score in 28 joints (DAS-28), Short-Form 36 (SF-36), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale, and Visual Analog Scale.

Results

Among the patients with RA, 42 (20.8%) had concurrent FM. Compared with patients without FM, patients with FM had higher DAS-28 (6.0 vs. 4.4, P = 0.011) and notably higher tender joint counts (16.5 vs. 4.5, P < 0.001). Patients with RA and FM had worse HAQ scores (1.24 vs. 0.66, P < 0.001) and lower SF-36 scores (28.6 vs. 58.2, P < 0.001). Patients with RA and FM experienced more fatigue (88.1% vs. 50.6%, P < 0.001) and had higher anxiety (10 vs. 4, P < 0.001) and depression scores (12 vs. 6, P < 0.001). No significant differences in erythrocyte sedimentation rate, C-reactive protein concentration, morning stiffness period, or swollen joint counts were found between the groups.

Conclusions

Patients with RA and FM had higher disease activity, a worse functional and psychological status, and poorer quality of life. The DAS-28 may have been overestimated in these patients. When patients with RA do not reach remission, FM should be considered.

Key Points

• Patients with rheumatoid arthritis and fibromyalgia had a worse functional and psychological status compared with those with rheumatoid arthritis alone.

• When patients with rheumatoid arthritis do not reach remission, fibromyalgia should be considered.

• Physicians should avoid overtreatment and enable these patients to receive the treatment, such as non-drug interventions, that they need.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Editage (www.editage.cn) for English language editing.

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Author notes

    Authors and Affiliations

    1. Department of Rheumatology and Immunology, Peking University People’s Hospital, 11 Xizhimen South Street, Beijing, China

      Chao Gao, Hua Zhong, Lihong Chen, Li Wang, Hong Yao, Xiaowei Huang, Yubo Jia, Chun Li & Tian Liu

    2. Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis, Beijing, China

      Chun Li & Tian Liu

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    1. Chao Gao
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    2. Hua Zhong
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    3. Lihong Chen
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    4. Li Wang
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    5. Hong Yao
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    6. Xiaowei Huang
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    7. Yubo Jia
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    8. Chun Li
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    9. Tian Liu
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    Contributions

    CG conducted most of the experiments. LC and TL conceived the study and design it. HZ drafted the manuscript and participated in data analysis. LW, HY, XH, and YJ helped to collect data. TL and CL participated in interpretation of results and reviewed the manuscript. All authors approved the final version to be submitted for publication.

    This study was supported by funds from the National Natural Science Foundation of China (81671609), the Beijing Science and Technology Planning Project (Z191100006619111), the Beijing Municipal Natural Science Foundation (7192211), and the Peking University People’s Hospital Research and Development Found (RDN2019-02).

    Corresponding authors

    Correspondence to Lihong Chen or Tian Liu.

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    The authors’ equal contribution has been added.

    Chao Gao and Hua Zhong are shared first authors.

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    Gao, C., Zhong, H., Chen, L. et al. Clinical and psychological assessment of patients with rheumatoid arthritis and fibromyalgia: a real-world study. Clin Rheumatol 41, 1235–1240 (2022). https://doi.org/10.1007/s10067-021-06026-6

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    • DOI: https://doi.org/10.1007/s10067-021-06026-6

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