Fibromyalgia in patients with synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome: prevalence and s
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ORIGINAL ARTICLE
Fibromyalgia in patients with synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome: prevalence and screening Yirong Xiang 1 & Rui Jiao 1 & Yihan Cao 1 & Dongfeng Liang 2 & Weihong Zhang 3 & Yanying Yu 1 & Wen Zhang 1 & Chen Li 4 Received: 18 April 2020 / Revised: 21 August 2020 / Accepted: 12 September 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Objective To explore the prevalence, clinical characteristics, and screening strategy for fibromyalgia (FM) in patients with synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. Methods A total of 313 patients from a cohort of 354 SAPHO patients volunteered to participate in this study. Demographic, clinical and laboratory data were collected at baseline. Acute-phase reactants during the last 3 months were obtained. Patientreported outcomes (PROs) and FM evaluation were recorded by questionnaires. Results A total of 57 (18.2%) patients met the 2016 research criteria for FM. Compared to those without FM, these patients had significantly higher visual analog scale (VAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) scores (all p < 0.001). However, no differences in the erythrocyte sedimentation rate (ESR) or hypersensitive C-reactive protein (hs-CRP) levels were identified between the two groups. Patients with FM were also markedly older [odds ratio (OR) 1.072, p = 0.032] and had higher Fibromyalgia Rapid Screening Tool (FiRST) scores (OR 1.607, p = 0.016). The FiRST score showed a sensitivity of 50.9% and a specificity of 89.8%, and with a cutoff of 3, the FiRST score presented a high sensitivity of 84.2%. Conclusion The prevalence of FM among SAPHO patients was similar to that among patients with other rheumatic diseases. Concomitant FM in SAPHO syndrome was associated with older age and worse PROs. Different cutoff values for FiRST screening should be used in patients with SAPHO syndrome. Key Points • The prevalence of FM among SAPHO patients was similar to that among patients with other rheumatic diseases. • Concomitant FM in SAPHO syndrome was associated with older age, widespread pain, and worse PROs. • Different cutoff values for FiRST screening should be used in patients with SAPHO syndrome
Keywords Fibromyalgia . SAPHO syndrome . Patient-reported outcomes . Screening tool
Yirong Xiang, Rui Jiao and Yihan Cao contributed equally to this work. The work should be attributed to Peking Union Medical College Hospital. * Chen Li [email protected]
3
Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
1
Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
4
Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academ
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