EFFECT OF DULOXETINE ON THE EFFECTIVENESS OF TREATMENT OF PATIENTS WITH ANKYLOSING SPONDYLITIS AND COMORBIDITY WITH FIBROMYALGIA
Shapoval I.I., Stanislavchuk M.A.
Summary. Background. Treatment of ankylosing spondylitis (AS) remains a difficult task in rheumatology, not least due to the comorbidity of AS with other pathological conditions, including fibromyalgia (FM). EULAR recommends duloxetine for the correction of pain in FM; however, the effect of duloxetine on the effectiveness of treatment of patients with AF with FM remains uncertain. Aim of the study: to rate the effect of duloxetine on the effectiveness of treating patients with AS and comorbid FM. Methods and materials. In study participated 106 patients with AS, including 49 individuals with concomitant FM. Patients divided into three groups: 1st and 2nd groups received a standard treatment regimen, for patients of the 3rd group additionally prescribed duloxetine. The effectiveness of treatment evaluated according to the criteria of ASAS 20 and 40. Results. Standard therapy reduced disease activity, functional status and quality of life in patients with AS without FM, but didn’t cause significant regression of clinical symptoms in patients with concomitant FM. In patients with AS and FM’s presence, the chances of resistance to treatment were significantly higher (OR = 3.35; 95% CI 1.02–11.03). The use of duloxetine increased the effectiveness of treatment of patients with AS and FM and increased the chances of achieving ASAS 20 after 12 weeks (OR = 10.7; 95% CI 2.85–40.9, p<0.01). Conclusions. Fibromyalgia is an independent predictor of resistance to treatment in patients with AS.
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