Fibromyalgia Takes its Toll in People with Inflammatory Spine Disease

Patients with the inflammatory disease axial spondyloarthritis, affecting the spine, often are affected by fibromyalgia, which worsens the impact of the disease on their quality of life.

While both physical and psychological health is affected, the presence of fibromyalgia did not impact levels of inflammation or most disease symptoms unrelated to the spine.

The study, “The co-occurrence of axial spondyloarthritis and fibromyalgia: results from a national register (BSRBR-AS),” was presented at the Rheumatology 2017 Meeting, held April 25-27 in Birmingham, England.

Axial spondyloarthritis is a condition in which inflammation in the spine causes some vertebrae to fuse, making people develop a hunched posture. Unlike fibromyalgia, the disease is more common in men.

While physicians have noted that fibromyalgia sometimes appears among these patients, up to now the two conditions have not been the focus of a common study.

A research team at the University of Aberdeen in the U.K. recruited patients from The British Society for Rheumatology Biologics Register for Ankylosing Spondylitis (BSRBR-AS). Since 2015, patients included in the registry also are screened for fibromyalgia.

Of 886 patients included in the study, 69% were men and 17.7% — or one in six — were diagnosed with fibromyalgia. Included patients either had newly started treatments with antibodies against tumor necrosis factor (TNF) to harness the inflammation, or never had used any biologic drugs.

Those who had both axial spondyloarthritis and fibromyalgia scored higher on tools assessing the severity and impact of the spine condition. They also were more likely to have anxiety, depression and significant fatigue. In addition, they scored lower on quality-of-life measurements.

While only 3% of patients with axial spondyloarthritis stated being absent from work was a result of their condition, 17% of those with both conditions reported work absenteeism.

When working, 52% of those with fibromyalgia stated that their work was impaired about half the time. The number in patients with axial spondyloarthritis without fibromyalgia was 23%.

Levels of C-reactive protein — a marker of inflammation — were similar in the two groups of patients. The only non-spinal symptom that was more common among those with fibromyalgia was swollen joints.

The presence of fibromyalgia also was not different in patients who had a history of TNF-blocking therapy, compared to those who never used biological drugs.

“Developing management approaches that address the unmet needs of axSpA [axial spondyloarthritis] patients with co-morbid FM [fibromyalgia] should be a current research priority.” the team concluded.


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