Original Investigation

The Affect of Fibromyalgia on Disease Activity in Rheumatoid Arthritis Patients


  • Ahmet Bal
  • Nil Sayıner Çağlar
  • Sibel Çağlar Okur
  • Türkan Akın
  • Ebru Aytekin
  • Esra Çetin
  • Yasemin Pekin Doğan
  • İbrahim Halil Erdem
  • Özcan Ayşar

Received Date: 12.08.2014 Accepted Date: 27.12.2014 İstanbul Med J 2015;16(1):18-22


The aim of the study is to determine the effect of fibromyalgia (FM) on disease activity and quality of life in rheumatoid arthritis (RA) patients.


This was a randomized and prospective study conducted in 96 RA patients admitted to our rheumatic diseases outpatient clinic, diagnosed according to the American College of Rheumatology (ACR) 1987 criteria at least for 2 years. Data composed of demographical properties, painful and swollen joints, duration of morning stiffness, level of pain by Visual Analog Scale (VAS), number of used disease-modifying antirheumatismal drugs (DMARD), and disease duration of all patients. In addition C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and anticyclic citrullinated peptide (anti-CCP) levels were measured. Disease Activity Score 28 (DAS28) was used to assess disease activity and Health Assessment Questionnaire (HAQ) and short form (SF-36) were used to assess the quality of life. FM diagnosis was primarily made on the basis of the ACR 1990 FM criteria. After then, two groups were generated as FM-positive and FM-negative patients. Disease activity (DAS28), quality of life (HAQ and SF-36), morning stiffness durations, numbers of painful and swollen joints, pain levels by VAS, number of DMARDs used, duration of disease, and laboratory diagnosis as well as activity parameters (CRP,ESR,RF, and anti-CCP) were compared between the two groups.


There was no significant difference in the duration of morning stiffness, duration of disease, number of used DMARDs, CRP,ESR, RF, and anti-CCP (p>0.05) between the two groups.

RA patients with FM showed significantly higher scores of VAS, HAQ, and DAS28 and more painful joints than RA patients without FM; SF 36 scores were significantly lower in FM patents (p<0.05).


FM adversely affects disease activity and quality of life in patients with RA. It may be help full to consider FM while evaluating disease activity in RA patients.

Keywords: Fibromyalgia, rheumatoid arthritis, disease activity, quality of life