Fibromyalgia (FM) syndrome & disease activity in systemic lupus erythematosus

To study the effect of fibromyalgia syndrome (FS) on the expression

of systemic lupus erythematosus (SLE) and on the measurement

of disease activity, we performed a cross-sectional study of

subjects with SLE. Eighty-seven subjects were studied and 22

(25.3%), all female, had FS (Yunus’ criteria). Disease

activity and organ system involvement were assessed using the

systemic lupus activity measure (SLAM) and using 10 cm visual

analogue scales (VAS) completed by both physician and patient.

No significant difference between FS and non-FS groups in the

objective measurement of disease activity was present, median

(range) SLAM scores being 5 (0-18) and 6 (0-24), respectively

(NS). Similarly, expression of SLE, as measured by the

prevalence of specific organ system involvement, was similar

in the two groups. In contrast the prevalence of

glucocorticoid use, antibodies to DSDNA and fulfilling four

ACR criteria was higher in the non-FS group. The rating of SLE

disease activity was affected by concomitant FS. Physician and

patient disease activity VAS correlated significantly with

SLAM scores in non-FS subjects (P < 0.001, Spearman analysis),

whereas in FS subjects, neither physician nor patient VAS

correlated with SLAM scores.

We conclude that FS is prevalent in individuals with SLE

and does not affect disease expression but may interfere with

the rating of disease activity.

Morand EF, Miller MH, Whittingham S, Littlejohn GO

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