Disease activity score in rheumatoid arthritis with or without secondary fibromyalgia

ABSTRACT

To correlate disease activity score [DAS-28] in the patients with rheumatoid arthritis [RA] with and without secondary fibromyalgia. Comparative cross-sectional study. Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad, from November 2011 to April 2012. Patients aged above 16 years diagnosed to have rheumatoid arthritis according to ACR/EULAR criteria 2010 were included in the study. Fibromyalgia [FM] was diagnosed by ACR 1990 criteria. Patients of other autoimmune diseases or psychiatric illnesses were excluded. DAS was determined and compared using t-test with significance at p < 0.05. The mean age of study subjects was 42.9 years. Thirty one out of total 138 patients had fibromyalgia [22.4%]. Female gender was predominant [92.0%]; being 96.8% in patients with and in 88.2% without fibromyalgia. The average DAS score was high [5.3 + 1.5] in fibromyalgia patients compared to those without fibromyalgia [3.9 + 1.2]; this difference in mean value was statistically significant [p = < 0.001]. DAS-28 is a useful tool for assessing rheumatoid arthritis disease status in outpatient setting, however, increased disease activity must be assessed for possible co-existence of fibromyalgia which can spuriously give high DAS value and adversely affect treatment decision