Patients with Rheumatoid Arthritis in Comparison to Other Connective Tissue Diseases Are Mostly Influenced by Concomitant Fibromyalgia Tomš J, Daňková.

Slides:

Advertisements

Similar presentations

Fibromyalgianess, Systemic Lupus Erythematosus & the Evaluation of SLE Activity R Katz 1, M Petri 2, E Karlson 3, G Alarcón 4, E Chakravarty 5, J Goldman.

Advertisements

Development and initial validation of the ‘Bristol Impact of Hypermobility’ (BIoH) questionnaire ST Palmer a, F Cramp a, R Lewis b, G Gould c, E Clark.

How Shall Fibromyalgia Be Diagnosed? A Comparison of Clinical, Survey and ACR Criteria Robert S Katz 1, Frederick Wolfe 2, Kaleb Michaud 2,3 1 Rush University.

1 Fibromyalgia: A Chronic Widespread Neurologic Pain Condition Disease Overview, Diagnosis, and Management PBP00542 © 2009 Pfizer Inc. All rights reserved.

Balçova Thermal SpA,Physical Therapy And Rehabilitation Center, İzmir/TURKEY MSc.,PT.,Burcu APLAK ARIN.

Table 1. Comparison between the provisional diagnosis based on the proforma versus final diagnosis Early arthritis Rheumatoid arthritis 3 6 Psoriatic.

ARTIFICIAL DISC VERSUS FUSION A prospective randomised study with 2-year follow-up on 99 patients.

A Comparative Analysis of Croatian Immigrant's and the Australian Population's subjective quality of life and self-perceived health status Gorka Vuletić.

Health related quality of life and satisfaction with life in Croatia Gorka Vuletic, BPsychol, PhD Andrija Stampar School of Public Health Medical Faculty,

Measuring Signs and Symptoms in Rheumatoid Arthritis David R. Karp, MD, PhD Chief, Rheumatic Diseases UT Southwestern Medical Center David R. Karp, MD,

Background: Heart failure (HF) is an incurable life-long disease with poor prognosis. Symptoms such as dyspnea cause limitation in patients’ daily life.

Assessment of Lupus (SLE) Mortality in a Patient-Based Community Data Bank Frederick Wolfe 1, Kaleb Michaud 1,2, Tracy Li 3, Robert S. Katz 4 1 National.

Comorbidity in SLE Compared with Rheumatoid Arthritis and Non-inflammatory Disorders Frederick Wolfe 1, Kaleb Michaud 1,2, Tracy Li 3, Robert S. Katz 4.

 The Juvenile Arthritis Foot Disability Index (JAFI) (Andre et al, 2004) was the primary outcome measure of the impact of JIA on the foot.  The Child.

Jaw Pain: Characteristics and Prevalence in Fibromyalgia and other Rheumatic Disorders Robert S. Katz 1, Frederick Wolfe 2. 1 Rush University Med Center,

Non-Radiographic Spondyloarthritis Has Greater Work Instability than Other Spondyloarthritis Subtypes in a National Database Sherry Rohekar 1, Robert D.

PsA: Review of Available Assessment Instruments and Lessons from Trial Results Part II Christian Antoni Friedrich Alexander University Erlangen-Nürnberg.

The Association of Fibromyalgia Symptoms with SLE Outcome and Diagnosis Robert S. Katz 1, Frederick Wolfe 2, Kaleb Michaud 2, Carisa M. Cooney 3 1 Rush.

Fibromyalgia Patients Reading Self-Help Journals and in Internet Self-Help Groups: Are They Different from Patients in Clinical Practice? Robert Katz 1,

1 Assessing the Minimally Important Difference in Health-Related Quality of Life Scores Ron D. Hays, Ph.D. UCLA Department of Medicine October 25, 2006,

EFFICACY OF SPA THERAPY IN RHEUMATOID ARTHRITIS-A RANDOMISED CONTROLLED CLINICAL STUDY Mine Karagülle Department of Medical Ecology and Hydroclimatology.

The Incidence and Influencing factors of functional disability in Chinese Patients with Rheumatoid Arthritis West China School Of Nursing, West China Hospital,

Outcome measures for balneotherapy NATIONAL INSTITUTE OF RHEUMATOLOGY AND PHYSIOTHERAPY Budapest, Hungary Dr. LÁSZLÓ HODINKA Recommendations.

Long-term functional deficiencies of ICU-acquired weakness: a prospective study I Patsaki, G Sidiras, V Gerovasili, A Kouvarakos, E Polimerou, G Mitsiou,

EQ-5D and SF-36 Quality of Life Measures in Systemic Lupus Erythematosus: Comparisons with RA, Non-Inflammatory Disorders (NIRD), and Fibromyalgia (FM)

Reliability and validity of the adapted Spanish version of the Early Onset Scoliosis-24 questionnaire María del Mar Pozo-Balado, PhD Hiroko Matsumoto PhD.

Sick Leave in Patients with Chronic Pain due to Occupational Injury in an Employer-Financed Work-Injury Compensation System Sandy Lee, J Yap, PP Chen Pain.

Page 1INGID Meeting Budapest, 6 October 2006 Prognostic Factors for Improved Health-Related Quality of Life in Children and Adults With Primary Antibody.

Correlations among Pain Severity, Functional Impairment and Clinical Symptoms in Fibromyalgia Rebecca L. Ross PhD, RN, PMHNP-BC, Assistant Professor.

Outcome Measures in PsA Philip Mease MD Seattle, WA.

IMAGING NEURAL CORRELATES OF FATIGUE & PAIN IN PATIENTS WITH RA TREATED WITH TNF INHIBITORS FARHAN BARI SPR RHEUMATOLOGY WARN CONFERENCE 22 ND MAY 2014.

Date of download: 6/2/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Long-term Quality of Life After Treatment of Laryngeal.

Predictors of Functioning in Women with Fibromyalgia Syndrome (FMS) Alexa Stuifbergen, PhD, RN, FAAN Professor Dolores V.Sands Chair in Nursing Research.

Prevalence and clinical risk factors for interstitial lung disease in rheumatoid arthritis in a resource limited setting A Dasgupta, P Bhattacharyya, S.

Fibromyalgia Impact Questionnaire McGill Pain Questionnaire

The influence of depression symptoms and sleep quality on the functional level of FMS patients I. Bouloukaki1, L. Konstantara1, C. Mermigkis1, E. Markakis2,

Evaluation of sleep architecture and functional level in Fibromyalgia patients with and without obstructive sleep apnea syndrome I. Bouloukaki1, L. Konstantara1,

Positive Impact of Regular Circuit Training on Muscle Strength, Stability, Depression and Fatigue in Multiple Sclerosis Patients Sucha L, Kalincik T, Novotna.

Patients were considered not in MDA (MDA−) with a score of 0, 1, 2, 3 or 4 points and in MDA (MDA+) with a score of 5, 6 or 7 points.

Figure 1 Historical evolution of the clinical classification and

Proportion of patients reporting scores ≥age-matched and gender-matched normative PRO values at baseline and 24 weeks in the (A) AMBITION and (B) ADACTA.

Rhematoid Rthritis Respiratory disorders

Mean changes in the Short Form-36 subscales from baseline values for combined pulmonary fibrosis and emphysema (CPFE) (n=16), and chronic obstructive pulmonary.

Health-Related Quality-of-Life Measures: Evidence from Tunisian Population Using the SF-12 Health Survey Moheddine Younsi, PhD Value in Health Regional.

Poorer sleep quality among adult patients with pectus excavatum in Taiwan: A pilot study Yeung-Leung Cheng, MD, PhD, Chou-Chin Lan, MD, PhD, Yao-Kuang.

Responsiveness and clinically important differences for the WOMAC and SF-36 after hip joint replacement J.M. Quintana, Ph.D., A. Escobar, M.D., A. Bilbao,

Laila Hellgren, MD, Elisabeth Ståhle, MD, PhD

Mu Qin et al. JACEP 2017;j.jacep

(A) Quality of life scores in individuals with and without constipation. (A) Quality of life scores in individuals with and without constipation. (B) Quality.

Improvement in PROs, TJC, SJC and PGA at month 6 in patients achieving (A) ACR50, (B) CDAI LDA and (C) HAQ-DI

Correlations between observed patient-reported outcomes and disease activity scores at week 24. Correlations between observed patient-reported outcomes.

Seth D. Crockett, Quinn K. Lippmann, Evan S. Dellon, Nicholas J

Health-Related Quality of Life in Patients Attending a Gastroenterology Outpatient Clinic: Functional Disorders Versus Organic Diseases Magnus Simrén,

OR for baseline predictors of MDA at weeks 12, 24, 48, 96 and 144 by univariate analysis of observed data. OR for baseline predictors of MDA at weeks 12,

Additional efficacy outcomes for the 12-week study of Japanese patients with rheumatoid arthritis treated with baricitinib or placebo. Additional efficacy.

Column bar graphs showing Health Assessment Questionnaire (HAQ) scores and pain score on Visual Analogue Scale (VAS) (scale 0–10) that were collected at.

SF-36 domain scores at baseline and 24 weeks compared with age-matched and gender-matched normative values in the (A) AMBITION and (B) ADACTA trial populations.

Status of Patients Presently Living 9 to 13 Years After Orthotopic Heart Transplantation Roland Hetzer, Wolfgang Albert, Manfred Hummel, Miralem Pasic,

ID Dr. Natālija Nikrus, Dr. Maija Vikmane, Prof. Oskars Kalējs

Mean individual and summative SF-36 V2 scores before and 3 months after ablation. Mean individual and summative SF-36 V2 scores before and 3 months after.

Clinical response in patients with early and established RA at month 24. *p

Improvement in PROs, TJC, SJC and PGA at month 6 in patients achieving (A) ACR70, (B) CDAI REM and (C) SDAI REM. For tofacitinib 5 and 10 mg BID treatment.

Percentages of patients reporting improvements from baseline ≥minimum clinically important difference (MCID) and number needed to treat (NNT) in (A) patient-reported.

Mean Short-Form 36 (SF-36) domain scores at baseline and 6 months in patients receiving active or placebo corticosteroids, cDMARDs or TNFis. Mean Short-Form.

Spydergram of mean SF-36 domain scores at baseline and weeks 12 (A) and 24 (B) for sarilumab 150 mg and 200 mg+csDMARDs compared with placebo+csDMARDs.

Spider plot of the unstandardised SF-36v2 subscales, comparing our HCM population with the mean for the general population (aged 45–54 years). Spider plot.

Proportion of patients reporting improvements from baseline in patient-reported outcomes (PROs) ≥ the MCID at (A) 16 weeks in OPTION, (B) 12 weeks in BREVACTA.

Explanatory power of the LPA solution for clinical and functional outcomes compared with the conventional threshold-based discordance definition. Explanatory.

LPA groups display vastly different outcomes.

Post hoc analysis of differences from placebo in the percentage of patients reporting improvements ≥MCID at week 24. Post hoc analysis of differences from.

Presentation transcript:

Patients with Rheumatoid Arthritis in Comparison to Other Connective Tissue Diseases Are Mostly Influenced by Concomitant Fibromyalgia Tomš J, Daňková M, Hrnčíř Z 2 nd Department of Medicine Faculty of Medicine and University Hospital Faculty of Medicine and University Hospital Hradec Králové, Czech republic

Abstract Background: A number of clinical studies documented that fibromyalgia (FM) can frequently accompany connective tissue diseases (CTD) as a concomitant syndrome. There is a lack of data about differencies in FM impact on individual CTD. Objectives: To compare the impact of concomitant FM on CTD in terms of pain intensity, disease activity, function disability and quality of life (QOL) in a regional, monocentric, cross-sectional study. Methods: 120 consecutive patients (pts) with rheumatoid arthritis (RA), 91 pts with systemic lupus (SLE), 30 pts with polymyositis/dermatomyositis (PM/DM) and 30 pts with systemic sclerosis (SSc) were examined in our outpatient rheumatology department on the presence of FM (ACR criteria,1990). Standard Manual Tender Point Survey was used for the examination of FM tender points. The following data were recorded: demographic data, tender point count (TPC), pain, fatigue and stiffness intensity on a 100 mm visual analog scale (VAS), Fibromyalgia Impact Questionnarie (FIQ) score and disease activity indices according to individual CTD representatives (DAS-28, SLEDAI, serum muscle enzymes). Health Assessment Questionnarie (HAQ) and Short Form 36 items (SF-36) were used for evaluation of functional disability and QOL, respectively. Statistical analysis was based on Kruskal- Wallis nonparametric tests comparing mutually all the CTD cohorts with and without FM. Patient file with SSc and FM was not included into the analysis due to small quantity. Results: FM diagnosis was established in 25 (20.8%) pts with RA, 10 (11.0%) pts with SLE, 4 (13.3%) pts with PM/DM and 1 patient with SSc (3.6%). CTD groups with concomitant FM were shown to have significantly higher levels of pain, fatigue, stiffness, TPC and FIQ (p <0.05). RA/FM pts reached the highest average intensity of pain (VAS pain 63.7 mm), the worst disability level (HAQ 1.832) and the most reduced QOL in some of SF-36 domains. Disease activity assessment was significantly influenced only in RA pts (DAS-28 in RA with and without FM 5.35  1.1 vs  1.4; p < ). Conclusion: Concomitant FM appears most frequently in pts with RA in comparison to other CTD. RA patients are also mostly influenced by FM at the level of pain perception, disability and QOL. This FM impact contributes to significant difficulties in RA disease activity assessment unlike other CTD.

Background and Objectives Background A number of clinical studies documented that fibromyalgia (FM) can frequently accompany connective tissue diseases (CTD) as a concomitant syndrome (Table). There is a lack of data about differencies in FM impact on individual CTD. Objectives To compare the impact of concomitant FM on connective tissue diseases in terms of pain intensity, disease activity, fucntion disability and quality of life in regional, monocentric, cross-sectional study. Rheumatoid arthritis Systemic lupus erythematodes Poly-/ dermatomyositis Systemic sclerosis Sjögren syndrome Frequency of concomitant fibromyalgia in CTD (%) 6.6 – – 25.08,0 – – 22.0

Methods clinical examination of the patients with CTD attending outpatient rheumatology department (terciary centre) diagnosis of RA according to the criteria ACR 1987, SLE according to the criteria ACR 1982/1997, PM/DM according to Bohan´s and Peter´s criteria (1975), SSc according to the criteria ACR 1980 examination focused on the presence of FM according to the criteria ACR 1990 FM tender point examination - the protocol MTPS (Standardised Manual Tender Point Survey) Okifuji et al. J Rheumatol 1997;24: disease activity - DAS-28, SLEDAI, creatinkinase (myoglobin) functional disability - HAQ (Health assessment questionnaire) quality of life - SF-36 (Short Form 36 items) FIQ (Fibromyalgia Impact Questionnaire) SDS (Zung´s self-rating depression scale) pain, fatigue and stiffness intenstity evaluated on a 100 mm horizontal visual analogue scale (VAS) statistical analysis was based on Kruskal-Wallis nonparametric tests comparing mutually all the CTD cohorts with and without FM patient file with SSc and FM was not included into the analysis due to small quantity

Patient groups RASLEPM/DMSSc n (PM = 18, DM = 12) 30 Age (years – median, range) 57.0 ( ) 43.0 (18 -75) 50.0 ( ) 61.5 ( ) Sex ratio (M : F) 29 : 91 (24.2 : 75.8 %) 6 : 85 (6.6 : 93.4 %) 13 : 17 (43.3 : 56.7 %) 10 : 20 (33.3 : 66.6 %) Disease duration (years – median, range) 11.2 ( ) 8.8 ( ) 3.6 ( ) 6.0 ( ) Disease activity DAS ± 1.52 SLEDAI 3 (0 – 13) CK = 2.15 µkat/l (0.55 – 30.9) Myogl = 50.1 µkat/l (22.3 – 650.5) Not evaluated Explanation: data of disease activity are median and 5th – 95th percentile

Results I. RA/FM-RA/FM+SLE/FM-SLE/FM+PDM/FM-PDM/FM+SSc/FM- N Age (years) 55.9 ± ± ± ± ± ± ± 9.9 Sex ratio (M : F) 25 : 704 : 216 : 750 : 1013 : 130 : 410 : 19 Disease duration (years) 10.9 ± ± ± ± 7.02, ± 5.2 Disease activity * DAS ± 1.4 * DAS ± 1.1 SLEDAI 3 (0 – 13) SLEDAI 3.5 (0 – 9.0) CK = 2.00 µkat/l (1.3 – 5.1) Myogl = 52.6 µkat/l (30.0 – 135.0) CK = 2.20 µkat/l (1.9 – 9.6) Myogl = 37,2 µkat/l (27.0 – 96.0) Not Evaluated Explanation: parameters characterized by more numbers: average ± standard deviation or median and5th-95th percentile * Difference in DAS-28 is statistically significant: p <

Results II. Explanation: CTD – connective tissue diseases, VAS - visual analogue scale, FIQ – Fibromyalgia Impact Questionnaire, TPC – tender point count CTD groups with concomitant FM were shown to have significantly higher levels of pain, fatigue, stiffness, TPC and FIQ (p <0.05). RA/FM+ patients reached the highest average intensity of pain (VAS pain 63.7 mm).

Results III. Explanation: HAQ - Health Assessment Questionnaire, SDS – Zung´s depression self-rating scale RA/FM+ patients reached the worst disability level (HAQ 1.832), p < 0.05, and the highest depression score (SDS 0.508), p < 0.05.

p < 0,001 Values on individual axes are mean scores of quality of life domains. PF – physical functioning, RP – role physical, BP – bodily pain, GH – General health, VT – vitality, SF – social functioning, RE - role emotoinal, MH – mental health. Results IV. Short Form 36 items (SF-36)

p < p = p = p < Disease Activity in Rheumatoid arthritis Explanation: DAS-28 – disease activity score evaluating 28 joints, TJC – tender joint count, SJC – swollen joint count, FW – erythrosite sedimentation rate, VAS - visual analogue scale

Relative count Relative count %

Conclusion concomitant fibromyalgia appears most frequently in patients with rheumatoid arthritis in comparison to other connective tissue disease RA patients are mostly influenced by FM at the level of pain perception, disability and in some domains of life quality FM impact contributes to significant difficulties in RA disease activity assessment unlike other connective tissue diseases