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Background: Fibromyalgia is a complex chronic syndrome characterized by widespread pain, fatigue, sleep impairment, and dysfunction of the autonomic nervous system. Its prevalence is higher in patients suffering from immune-mediated rheumatic diseases (IMRD), ranging from 10-30%. Concomitant fibromyalgia, also referred to as secondary fibromyalgia, significantly impacts pain perception, quality of life, and the response to treatment in patients with IMRD. Objectives: To Compare Fibromyalgia Features in Patients With and Without Concomitant IMRD. Methods: A comprehensive clinical and laboratory assessment was performed on 318 patients with chronic musculoskeletal pain syndromes during a rheumatology-led two-week multimodal inpatient program. This program included psychiatric evaluation and sleep analysis by actigraphy. Fibromyalgia was diagnosed in 152 patients using the ACR2010 and/or FiRST criteria. Among these, 56 out of 318 patients suffered from a confirmed IMRD (Figure 1) according to their respective classification criteria. Univariate analysis was conducted to compare fibromyalgia patients with and without concomitant IMRD. Results: In this cohort, 25 out of 56 (45%) patients with IMRD fulfilled the ACR2010 or FiRST criteria for fibromyalgia. The presence of IMRD was associated with the use of DMARDs, cortisone, biologics, or NSAIDs, as well as with peripheral inflammatory pain, enthesopathy, and CRP levels >10 mg/L. Higher rates of hypermobility (Beighton score) as well as sleep problems or pain in childhood or adolescence were found in the fibromyalgia/IMRD group (see Table 1). Conversely, patients with both fibromyalgia and IMRD had lower levels of kinesiophobia and and a tendency towards lower FiRST scores compared to fibromyalgia patients without concomitant IMRD. Conclusion: Generally, fibromyalgia features are similar in patients with or without concurrent IMRD. However, IMRD patients with fibromyalgia tend to experience more peripheral inflammatory and enthesiopathic pain, and they exhibit less kinesiophobia. The presence of hypermobility, as well as pain or sleep problems that have persisted since childhood, may have influenced the diagnosis of IMRD in this cohort. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: Thomas Hügle Roche, Novartis, GSK, BMS, Janssen, Galapagos, Atreon, Vtuls, Johanna Mettler: None declared, Pedro Ming Azevedo: None declared.
Hügle et al. (Sat,) studied this question.