Disease Activity Indices In Patients Of Rheumatoid Arthritis With Concomitant Fibromyalgia

Abstract

Background: Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease characterized by joint inflammation and progressive damage. Fibromyalgia syndrome (FMS), a condition marked by widespread pain and fatigue, frequently coexists with RA, complicating disease assessment and management. This study aimed to evaluate the impact of fibromyalgia on disease activity in RA patients, focusing on the Disease Activity Score 28 (DAS28) and Clinical Disease Activity Index (CDAI). Methods: A total of 50 RA patients diagnosed according to the 2010 American College of Rheumatology (ACR) criteria were enrolled in this cross-sectional study. Patients were divided into two groups: Group I (RA with fibromyalgia) and Group II (RA without fibromyalgia). Socio-demographic, clinical, and disease activity data were collected. Disease activity was assessed using DAS28 and CDAI, while inflammatory markers (ESR, CRP) and serological tests (RF, anti-CCP) were also measured. Results: The mean age of participants was 48.04 ± 13.78 years. Fibromyalgia was present in 24% of RA patients. No significant differences were observed in inflammatory markers (ESR, CRP) or serological tests (RF, anti-CCP) between the two groups. However, disease activity indices were significantly higher in patients with fibromyalgia. All patients in Group I had high DAS28 scores (>5.1), with a mean of 7.22 ± 0.81, compared to 65.8% in Group II (mean DAS28 5.77 ± 1.32). CDAI scores were also significantly higher in Group I (43.5 ± 6.14) compared to Group II (25.79 ± 15.67). Conclusion: Our findings suggest that the presence of fibromyalgia significantly increases disease activity in RA patients, as reflected by higher DAS28 and CDAI scores. These results highlight the importance of considering fibromyalgia when assessing disease activity in RA, as it may lead to an overestimation of disease severity and impact treatment decisions.