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Background: Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory disease characterised by pain in peripheral joints accompanied by functional impairment. Fibromyalgia (FM) is a well-known comorbidity in RA, a syndrome characterized by chronic diffuse pain, fatigue, poor sleep, and other somatic symptoms. Screening of FM in RA patients may change the physical evaluation and the degree of RA treatment. Objectives: The aim of this study is to evaluate the performance of the Fibromyalgia Rapid Screening Tool (FIRST) self-questionnaire for the detection of FM associated with RA and determine the prevalence of FM in RA patients, and its related factors. Methods: A cross sectional study of patients with RA diagnosed according to ACR/EULAR 2010 criteria. Epidemioclinical characteristics, Disease Activity Score 28 (DAS28) and Health Assessment Questionnaire (HAQ) were assessed for each patient. The First questionnaire, consisting of six questions each taking one point, is a screening questionnaire for fibromyalgia if at least a score of 5 out of 6 is obtained. FM was diagnosed using the criteria of the American College of Rheumatology (ACR) 2010. Results: The study included 60 patients with RA, 7 men and 53 women, with a mean age of 54 ±12 years; range 27 to 75 years. The mean duration of the disease was 12 ±8 years. When patients were evaluated with DAS28, it was seen that 2 patients achieved remission, 9 patients had low disease activity, 34 patients had moderate disease activity, and 15 patients had high disease activity. The self-questionnaire was completed by all patients. A score ⩾5/6 was obtained for 26/60 patients (43.3%) with a mean FIRST questionnaire score of 3.92 ± 1.5. Of the 26 positive tests, 18 (30%) patients fulfilled ACR FM criteria. The mean of Widespread Pain Index (WPI) was 7.5 ±3.7. The mean of Symptom Severity (SS) scale was 7 ±1.7. The use of corticosteroids and biological therapy in patients with FM was more frequent than in patients without FM (P=0.05). Patients with RA with FM had a higher disease activity (50 % had high disease activity), and none of our RA with FM patients were in remission. Rheumatoid factor was positive in 55.6% and 44.2% and anti-CCP was positive in 55.6% and 41.9% of the patients with or without FMS, respectively (p>0.05). RA-FM had higher DAS-28 score (5.2 vs 4.3, p=0.03) and had worse HAQ (1.7 vs 1.1, P=0.17). There was no significant correlation between DAS28 and Widespread Pain Index (WPI) and Symptom Severity (SS) scale. Conclusion: This investigation estimated the prevalence and health effects of concomitant FM in RA patients. High rates of FM are reported in this rheumatic disease. Fibromyalgia has a negative impact on the evolution of RA. Making a screening strategy is vitally important to avoid over or inadequate treatment. The FIRST questionnaire is easy and straightforward to use. REFERENCES: NIL. Acknowledgements: In this section devoted to acknowledgements, I would like to express my deep gratitude to all those who have accompanied me in this work. I would especially like to thank my family, whose constant encouragement fuelled my perseverance throughout the completion of this work. Disclosure of Interests: None declared.
Mnif et al. (Sat,) studied this question.