Prevalence and clinical predictors of fibromyalgia in patients with rheumatoid arthritis

Authors

  • Aparna Deb Department of Medicine, Upazila Health Complex, Fatikchari, Chittagong, Bangladesh
  • Mohammad I. Sultan Department of Rheumatology, Kurmitola General Hospital, Dhaka, Bangladesh
  • Mohammed T. Islam Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh
  • M. Saiful Arif Department of Rheumatology, Chittagong Medical College, Chittagong, Bangladesh
  • Protyay Dey Department of Nephrology, Chittagong Medical College, Chittagong, Bangladesh
  • Mrinal Saha Department of Medicine, Upazila Health Complex, Kulaura, Sylhet, Bangladesh
  • Rayhana Begum Department of Ophthalmology, Chittagong General Hospital, Chittagong, Bangladesh
  • Sangita Dhar Department of Nephrology, Chittagong Medical College, Chittagong, Bangladesh
  • Tamanna Tabassum Department of Obstetrics and Gynaecology, Upazila Health Complex, Fatikchari, Chittagong, Bangladesh
  • Sayeema Kabir Department of Paediatrics, Dhaka Medical College Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20260812

Keywords:

Rheumatoid arthritis, Fibromyalgia, DAS28, Depression, Disease activity

Abstract

Background: Fibromyalgia (FM) is a common disorder in patients with rheumatoid arthritis (RA) and contributes to the inflation of disease activity scores because of a high symptom similarity. Objective of the study was to estimate the prevalence of FM in patients with RA and to identify clinical predictors.

Methods: A total of 150 RA patients were enrolled in this cross-sectional study. FM status was determined by WPI and SSS. Sociodemographic, clinical, laboratory and disease activity parameters were evaluated.

Results: The prevalence of fibromyalgia in patients with RA was 24%. The participants had a mean age of 52.02±12.13 years and were predominantly female at an 81.3% rate. Patients with both RA and FM presented with more swollen joint count, higher patient VAS scores, DAS28 scores, CDAI scores and SDAI compared to those without FM. Depression and fatigue were more common in FM-positive patients.

Conclusions: Nearly one fourth of patients with RA had FM diagnosed concurrently. Psychological and subjective disease components were strongly correlated with FM in this study, indicating that higher disease activity scores may not always represent an active inflammation.

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References

Smolen JS, Landewé R, Bijlsma J, Burmester G, Chatzidionysiou K, Dougados M, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis. 2017;76(6):960-77. DOI: https://doi.org/10.1136/annrheumdis-2016-210715

Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. 2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569-81. DOI: https://doi.org/10.1002/art.27584

Prevoo ML, van ’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts: Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38(1):44-8. DOI: https://doi.org/10.1002/art.1780380107

Aletaha D, Nell VP, Stamm T, Uffmann M, Pflugbeil S, Machold K, et al. Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: Validation of a clinical activity score. Arthritis Res Ther. 2005;7(4):R796-806. DOI: https://doi.org/10.1186/ar1740

Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010;62(5):600-10. DOI: https://doi.org/10.1002/acr.20140

Clauw DJ. Fibromyalgia: A clinical review. JAMA. 2014;311(15):1547-55. DOI: https://doi.org/10.1001/jama.2014.3266

Pollard LC, Kingsley GH, Choy EH, Scott DL. Fibromyalgic rheumatoid arthritis and disease assessment. Rheumatology (Oxford). 2010;49(5):924-8. DOI: https://doi.org/10.1093/rheumatology/kep458

Ranzolin A, Brenol JC, Bredemeier M, Guarienti J, Rizzatti M, Feldman D, et al. Association of concomitant fibromyalgia with worse disease activity score in patients with rheumatoid arthritis. Rheumatol Int. 2009;29(7):781-6.

Wolfe F, Michaud K, Pincus T. Clinical significance of fibromyalgia in patients with rheumatoid arthritis. Arthritis Care Res (Hoboken). 2011;63(5):722-9.

Coury F, Rossat A, Tebib A, Letroublon MC, Tebib JG. Rheumatoid arthritis and fibromyalgia: A frequent unrelated association complicating disease management. Arthritis Rheum. 2009;61(5):659-64. DOI: https://doi.org/10.3899/jrheum.080366

Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: A systematic review and meta-analysis. Rheumatology (Oxford). 2013;52(12):2136-48. DOI: https://doi.org/10.1093/rheumatology/ket169

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Published

2026-03-24

How to Cite

Deb, A., Sultan, M. I., Islam, M. T., Arif, M. S., Dey, P., Saha, M., Begum, R., Dhar, S., Tabassum, T., & Kabir, S. (2026). Prevalence and clinical predictors of fibromyalgia in patients with rheumatoid arthritis. International Journal of Research in Medical Sciences. https://doi.org/10.18203/2320-6012.ijrms20260812

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Original Research Articles