Clinical and Serologic Phenotyping and Damage Indices in Patients With Systemic Lupus Erythematosus With and Without Fibromyalgia.
Clinical and Serologic Phenotyping and Damage Indices in Patients With Systemic Lupus Erythematosus With and Without Fibromyalgia.
复制标题
伴有或不伴有纤维肌痛的系统性红斑狼疮患者的临床和血清学表型及损伤指数。
DOI：
10.1002/acr2.11641
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发表时间：
2024
影响因子：
3.4
通讯作者：
Izmirly,Peter
中科院分区：
文献类型：
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作者：
Corbitt,Kelly;Carlucci,PhilipM;Cohen,Brooke;Masson,Mala;Saxena,Amit;Belmont,HMichael;Tseng,Chung-E;Barbour,KamilE;Gold,Heather;Buyon,Jill;Izmirly,Peter
目的鉴于纤维肌痛 (FM) 经常与自身免疫性疾病同时发生，本研究旨在客观评估多种族/族裔系统性红斑狼疮 (SLE) 患者队列中的 FM。方法在风湿科医生亲自就诊期间，使用 2016 年 FM 分类标准对 SLE 患者进行 FM 筛查。我们评估了狼疮国家评估 (SELENA)-SLE 疾病活动指数 (SLEDAI) 评分、SLE 分类标准和系统性狼疮国际合作诊所损害指数中雌激素的混合安全性。我们比较了患有和不患有 FM 的患者，如果存在差异，则将患有 FM 的患者与患有非 FM 相关慢性疼痛的患者进行比较。结果 316 名 SLE 患者完成了 FM 问卷。 55 名 (17.4%) 符合 FM 标准。 FM 患者的种族构成与非 FM 患者不同 (P= 0.023)，原因是亚洲 FM 患者较少。 SLE 病程、SELENA-SLEDAI 评分或活性血清学没有差异。与非 FM 组 (1.9%) 相比，FM 组 (16.4%) 的活动性关节炎更多 (P<0.001)。在 FM 或非 FM 慢性疼痛 (r= 0.009; -0.024) 患者中，广泛疼痛指数和症状严重程度评分与 SLE 活动程度 (r= -0.016; 0.107) 不相关。就标准而言，FM 患者肾炎较少，颧骨皮疹较多。系统性狼疮国际合作诊所损伤指数在各组之间没有差异。 结论 除关节炎外，伴有 FM 的 SLE 患者在临床或血清学上与不伴有 FM 的患者没有其他区别，并且广泛疼痛指数和症状严重程度评分指数与 SLEDAI 不相关。这些观察结果支持进一步了解 FM 在 SLE 中的基础生物学的重要性。
ObjectiveGiven fibromyalgia (FM) frequently co‐occurs with autoimmune disease, this study was initiated to objectively evaluate FM in a multiracial/ethnic cohort of patients with systemic lupus erythematosus (SLE).MethodsPatients with SLE were screened for FM using the 2016 FM classification criteria during an in‐person rheumatologist visit. We evaluated hybrid Safety of Estrogens in Lupus National Assessment (SELENA)‐SLE Disease Activity Index (SLEDAI) scores, SLE classification criteria, and Systemic Lupus International Collaborating Clinics damage index. We compared patients with and without FM and if differences were present, compared patients with FM with patients with non‐FM related chronic pain.Results316 patients with SLE completed the FM questionnaire. 55 (17.4%) met criteria for FM. The racial composition of patients with FM differed from those without FM (P= 0.023), driven by fewer Asian patients having FM. There was no difference in SLE disease duration, SELENA‐SLEDAI score, or active serologies. There was more active arthritis in the FM group (16.4%) versus the non‐FM group (1.9%) (P< 0.001). The Widespread Pain Index and Symptom Severity Score did not correlate with degree of SLE activity (r= −0.016; 0.107) among patients with FM or non‐FM chronic pain (r= 0.009; −0.024). Regarding criteria, patients with FM had less nephritis and more malar rash. Systemic Lupus International Collaborating Clinics damage index did not differ between groups.ConclusionExcept for arthritis, patients with SLE with FM are not otherwise clinically or serologically distinguishable from those without FM, and Widespread Pain Index and Symptom Severity Score indices do not correlate with SLEDAI. These observations support the importance of further understanding the underlying biology of FM in SLE.