Presence of fibromyalgia in psoriatic arthritis linked to a host of other problems

Among patients with psoriatic arthritis (PsA), those with coexisting fibromyalgia also appear to have enthesopathy, poor quality of life, sleep disturbance, and fatigue, a study reports.

The analysis included 50 PsA patients (mean age, 49.5 years; 62 percent female) diagnosed according 2016 ACR criteria. Their demographic and clinical characteristics were recorded. Disease activity and enthesopathy were assessed using Disease Activity Score‐28 (DAS‐28) and Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), respectively.

Functional assessment scales in this study were Psoriatic Arthritis Quality of Life (PsAQoL), Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF), and Fibromyalgia Impact Questionnaire (FIQ).

Mean disease duration of the cohort was 7.5 years. Thirty‐two patients (64 percent) had fibromyalgia, and 27 reported poor sleep quality (54 percent; including 24 with fibromyalgia). Generally, PsA patients with versus without this condition had significantly higher MASES, PSQI, MAF, and PsAQoL scores (p<0.05).

FIQ scores were significantly higher in female than male PsA patients (mean, 40.1 vs 25.2; p=0.03).

The Mann‐Whitney U test showed FIQ to be significantly correlated with the following functional parameters: MASES (p<0.0005), PSQI (p<0.0005), MAF (p<0.0005), and PsAQoL (p<0.0005). A moderate correlation was found between FIQ and DAS‐28 (p=0.03).

Fibromyalgia is a common comorbid disease in PsA, similar to other inflammatory rheumatic diseases. The findings indicate that the severity and impact of fibromyalgia in PsA patients increase (higher FIQ scores) with female gender, higher disease activity, greater scores of enthesopathy, worse QoL, poor sleep, and increased fatigue levels.

As such, recognizing and treating fibromyalgia in PsA can improve QoL and alleviate fatigue and sleep disturbances by affecting disease activity and entheseal involvement.