PREVALENCE AND CLINICAL FEATURES OF FIBROMYALGIA ACCORDING TO THE CRITERIA ACR1990, mACR2010, AND SIQR SCALE IN UKRAINIAN COHORT OF PATIENTS WITH RHEUMATOID ARTHRITIS
Perebetyuk L.S., Stanislavchuk M.A.
Summary. To determine the frequency and clinical features of fibromyalgia (FM) in patients with rheumatoid arthritis (RA) on the basis of criteria ACR1990, new modified criteria mACR2010 and the scale SIQR. The study involved 125 patients with RA (100% women) aged 49.6±12,8 years, with moderate to high disease activity (DAS28>3.2). Screening of RA patients for the presence of fibromyalgia (FM) was carried out in accordance with the criteria ACR1990, mACR2010, and scale SIQR. The diagnosis of FM was set in the presence in patients with RA at least 11 of 18 specific tender points (TP ≥11) and at least 13 of 31 points regarding fibromyalgianess scale (FS ≥3). The prevalence of FM in Ukrainian cohort of patients with RA was 24.0%, in accordance with the criteria ACR1990 (number of TP ≥11) and 36.8% according to the mACR2010 (FS ≥13). In 12.8% of patients with RA FS ≥13 the number of sub-threshold TP was — 9.0 (8.8; 10.0), suggesting that there is incomplete FM syndrome. Criteria mACR2010 allow us to identify FM in patients with RA with a sensitivity of 93.8% and a specificity of 82.8%. Between the number of TP and FS there is a strong correlation (r=0.79; p<0.01). High level of SIQR scale associates with increased value of FS (r=0.62; p<0.01). In SIQR scale greatest diagnostic value has the scale «symptoms» with the cut-off point ≥21, sensitivity is 87.0% and specificity — 91.1%. FM is a common comorbid condition in the Ukrainian cohort of patients with RA. In patients with RA FM frequency in accordance to criteria mACR2010 is significantly higher than regarding criteria ACR1990. Criteria mACR2010 and SIQR scale allow to identify the patients with RA and incomplete FM syndrome.
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