AB0432 COMPARISON OF SYMPTOMATIC AND DISEASE-MODIFYING TREATMENT IN RHEUMATOID ARTHRITIS WITH CONCOMITANT FIBROMYALGIA

Abstract

BackgroundThere is evidence that concomitant fibromyalgia (FM) among rheumatoid arthritis (RA) patients make the management of RA challenging by inflating subjective disease activity parameters.ObjectivesThus, the aim of this study was to compare symptomatic and disease-modifying treatments in RA patients with and without concomitant FM.MethodsThis was a cross-sectional study including patients with an established RA according to the 2010 ACR/EULAR criteria. All patients were screened for concomitant FM by 2016 ACR criteria. Patients were divided into 2 groups: RA and RA+FM. Demographic and RA characteristics were collected. P<0.05 was accepted for significance. Multiple linear regression analysis performed, adjusting for clinical and demographic variables.ResultsEighty patients distributed into 40 patients in each group were recruited. Epidemiological characteristics, RA characteristics and disease activity scores were.comparable between groups. Coxitis and atlantoaxial subluxation were significantly more frequent in RA+FM group (p=0.006 and p=0.049 respectively). No significant difference in corticosteroids prescription was found between the groups (p=0.88), nor in non Non-steroidal anti-inflammatory drugs prescription (p=0.48). Of the RA patients with concomitant FM, 52% were treated with biological therapy vs. 18% of RA patients without concomitant FM (p = 0.04). Tumor necrosis factor inhibitors were the most frequently prescripted in the two groups (47.5% of RA patients with FM vs 12.5 in RA patients, p=0.03). No significant difference was noted between the groups regarding conventional Disease-modifying antirheumatic drugs (DMARDs) prescription (p=0.052). Multiple linear regression in RA+FM group showed that FM is an independent factor for biological DMARDs prescription (B=0.284, p=0.018).ConclusionOur study showed that concomitant FM in patients with RA was associated with a higher use of biological treatments. This raises the question of whether the more frequent use of biologics in these patients is justified by inflammation, or by persistent pain and other centrally mediated symptoms.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.