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Quality of life of patients with rheumatoid arthritis and comorbid fibromyalgia

https://doi.org/10.14412/2074-2711-2023-2-41-48

Abstract

Objective: to evaluate the impact of comorbid fibromyalgia (FM) on the quality of life (QoL) of patients with rheumatoid arthritis (RA).
Material and methods. The study involved 90 patients with confirmed RA who complained of chronic pain. All patients underwent general clinical and laboratory examination. FM was diagnosed according to the 2016 ACR criteria. The questionnaires assessed the presence and severity of fatigue (FSS), anxiety and depression (HADS), sleep disorders (PSQI), cognitive impairment (DSST), symptoms of central sensitization (CSI) and the neuropathic component of pain (DN4, PD). The severity of pain syndrome (PS) was assessed by 10-cm VAS at rest. QoL was assessed using the EQ-5D questionnaire.
Results. In the main (FM+) and control (FM-) groups, the average severity of PS according to VAS at rest was 7 and 4 cm (p<0.001), the average score on the CSI questionnaire was 50 and 38.5 (p<0.001), and according to the PD questionnaire – 17 and 11 (p<0.001), respectively. Analysis of the severity of comorbid disorders revealed significant differences between the groups in terms of such parameters as fatigue (p=0.003), anxiety (p=0.001), sleep quality (p<0.001) and cognitive impairment (p=0.021). The QoL of patients (according to EQ-5D) in the main group was significantly lower (0.52 vs. 0.59; p=0.003). Significant correlations were found between the QoL index according to EQ-5D and VAS, FSS and PD values in both groups, CSI, DN4, HADS-T parameters and the number of painful joints – only in the main group.
Conclusion. Concomitant FM significantly reduces the QoL of patients with RA. The main factors affecting QoL in patients with RA and comorbid FM were the intensity and neuropathic phenotype of PS, increased fatigue and anxiety. Patients with FM are also significantly more likely to have sleep and cognitive impairments.

About the Authors

N. A. Melikova
Department of Nervous System Diseases, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia; V.A. Nasonova Research Institute of Rheumatology
Russian Federation

8, Trubetskaya St., Build. 2, Moscow 119991;
34A, Kashirskoe Shosse, Moscow 115522


Competing Interests:

The investigation has not been sponsored. There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.



E. S. Filatova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation

34A, Kashirskoe Shosse, Moscow 115522


Competing Interests:

The investigation has not been sponsored. There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.



E. G. Filatova
Department of Nervous System Diseases, Institute of Professional Education, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

8, Trubetskaya St., Build. 2, Moscow 119991


Competing Interests:

The investigation has not been sponsored. There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.



A. M. Lila
V.A. Nasonova Research Institute of Rheumatology; Department of Rheumatology, Russian Medical Academy of Continuing Professional Education
Russian Federation

34A, Kashirskoe Shosse, Moscow 115522;
2/1, Barrikadnaya St., Build. 1, Moscow 125993


Competing Interests:

The investigation has not been sponsored. There are no conflicts of interest. The authors are solely responsible for submitting the final version of the manuscript for publication. All the authors have participated in developing the concept of the article and in writing the manuscript. The final version of the manuscript has been approved by all the authors.



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ISSN 2074-2711 (Print)
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