A prospective long-term study of fibromyalgia (FM) syndrome

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OBJECTIVE: To ascertain the long-term natural history of

fibromyalgia syndrome (FMS).

METHODS: Patients with a history

of FMS, seen in an academic rheumatology referral practice,

were originally surveyed soon after onset of symptoms, and

then were reinterviewed 10 years later in a prospective

followup cohort study. A validated telephone survey was

administered that inquired into current symptoms, medical care

and treatments used, and work disability. The results were

compared with the prior surveys.

RESULTS: Of the original 39

patients, there were 4 deaths. Of the remaining 35 patients,

29 (83%) were reinterviewed. Mean age at current survey was 55

years, and mean duration of symptoms was 15.8 years. All

patients had persistence of some fibromyalgia symptoms,

although almost half (48%) had not seen a doctor for them in

the last year. Moderate to severe pain or stiffness was

reported in 55% of patients; moderate to a lot of sleep

difficulty was noted in 48%; and moderate to extreme fatigue

was noted in 59%. These symptoms showed little change from

earlier surveys. In 79% of patients, medications were still

being taken to control FMS symptoms. Despite continuing

symptoms, 66% of patients reported that FMS symptoms were a

little or a lot better than when first diagnosed. Fifty-five

percent of patients said they felt well or very well in terms

of FMS symptoms, and only 7% felt they were doing poorly. With

the exception of sleep trouble, which was persistent, baseline

survey symptoms correlated poorly with symptoms at the 10-year

followup.

CONCLUSION: FMS symptoms last, on average, at least

15 years after illness onset. However, most patients

experience some improvement in symptoms after FMS onset.

Kennedy M, Felson DT

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