Presentation: The Impact of Concomitant Fibromyalgia on HAQ and DAS28 Evaluation in Patients with Rheumatoid Arhritis (2007)

1536 The Impact of Concomitant Fibromyalgia on HAQ and DAS28 Evaluation in Patients with Rheumatoid Arhritis

Background. The Disease Activity Score 28 (DAS28) and the Health Assessment Questionnaire (HAQ) are important clinical indexes used to evaluate the status and course of RA disease activity and disability, respectively. In some cases RA patients have concomitant fibromyalgia (FM), a syndrome defined by chronic, widespread pain, asthenia, and sleep disorders. Purpose. To evaluate the impact of FM on HAQ and DAS28 in RA. Methods. A study was conducted with consecutive patients with RA attending a university hospital rheumatology clinic between 2006 and 2007. All patients were evaluated for the presence of FM according the ACR criteria, and had DAS28 and HAQ evaluations. Results. A total of 257 RA patients were evaluated, and 28 (10.9%) had FM. No diferences were found in sex, age, disease duration or rheumatoid factor positivity between patients with RA with and without FM (table). Patients with RA and FM have higher disability score (HAQ 1.95 ± 0.58 ) and activity disease index (DAS28 5.54 ± 1.11) mean when compared with patients with RA without FM (HAQ 1.23 ± 0.85 and DAS28 4.15 ± 1.48, respectively; p < 0,001) (table) Conclusion. DAS28 and HAQ values in RA patients with coexisting FM should be regarded with caution, since high pain levels may lead to higher total scores, wich in such cases may indicate FM symptomatology rather than RA activity.
Comparison of patients with RA and RA plus FM
Comparison of patients with RA and RA plus FM
RARA plus FMp Value*
Number of patients22928
Women [nš (%)]190 (83)27 (96,4)0.093
Mean (SD) age, years55.2 (12.5)59.0 (12.9)0.138
Duration of RA (SD), years13.0 (8,4)13,0 (10.0)0.973
Rheumatoid factor positive (%)83.488.81.00
HAQ (SD)1.23 (0.85)1.95 (0.58)<0.001
DAS28 (SD)4.15 (1.48)5.54 (1.11)<0.001
* qui-square and student t test

 A. Ranzolin, None; J. Guarienti, None; M. Rizzatti, None; D.P. Feldman, None; R.M. Xavier, None; J.T. Brenol, None.