A comparative study of disease activity scores in early rheumatoid arthritis with and without fibromyalgia in Aswan university hospital

Background: Fibromyalgia (FM) often coexists with RA, The prevalence of FM in the general population is 2.7-5.1% and in RA it reaches a prevalence of up to 20%, It is characterized by chronic, widespread musculoskeletal pain, fatigue, sleep disturbance physical and psychological impairment, Concern has been raised regarding the validity of RA disease activity scores in patients with coexistent RA and FM, making a "treat-to target" strategy questionable in these patientsAim: The aim of this study was to evaluate disease activity scores in patients with rheumatoid arthritis (RA) with and without secondary fibromyalgia.Patients and Methods: This study is comparative cross-sectional study of 100 patients seen to rheumatology outpatient clinic in Aswan university hospital. The study included two groups of patients with early RA with and without fibromyalgia.Results: The frequency of FM in RA patients was 35% (92% female, 8% male). In RA patient with FM, the TJC and DAS median value were significantly higher than in patient without FM (P<0.001 ) , Median values of disease activity scores in RA patient with FM were higher than in patient Without FM (P< 0.034).Conclusion: Simplified disease activity index (SDAI) Score was significantly higher in RA patients with FM than those without FM, disease activity score (DAS) and clinical disease activity index (CDAI) were higher in FM cases but not reaching statistical significance. The current study also revealed that tender point count was positively correlated DAS and the number of tender joints.