Friday, 20 Oct 2017

You are here

Responder Criteria for Nonpharmalogical Treatment of Fibromyalgia.

Because of the subjective nature of fibromyalgia symptoms, tools for monitoring of disease activity and/or treatment assessment tools to evaluate effectiveness of nonpharmacological modalities are difficult to develop.
Due to the great variation in symptomatology among fibromyalgia patients, both pharmacological and nonpharmacological treatment for fibromyalgia are equally important while showing large individual variability in the long-term outcomes for fibromyalgia patients.

Responder criteria can help evaluate effectiveness of treatment and tailor to each individual patient, but no such criteria exists for nonpharmacological treatment per se.

Dr. Vervoort et al got on a mission to define responder criteria for multicomponent non-pharmacological treatment in FM.

In this project, candidate responder sets were identified in literature and tested for sensitivity and specificity in a cohort of 144 patients with FM receiving multicomponent non-pharmacological treatment. The therapist's judgement about patient's goal attainment and patients' perspective on health status change, assessed at 6 months after the start of treatment, were used as gold standard.

The groups defined 3 responder sets from the literature with the highest sensitivity and specificity. An additional 4 sets were formulated by expert group consensus: All responder criteria were defined and comprised combinations of domains of 1) pain; 2) fatigue; 3) patient global assessment (PGA); 4) illness perceptions; 5) limitations in activities of daily living (ADL); 6) sleep.

Of the literature-based responder sets, the OMERACT-OARSI responder set with patient's gold standard performed best (sensitivity 63%, specificity 75% and ROC area = 0.69). The expert-based responder set comprising the domains illness perceptions and limitations in ADL performed best (sensitivity 47%, specificity 96% and ROC area = 0.71).

Based on presented results, the group suggests further research should focus on the validation of those sets with acceptable performance.

 

 



Add new comment

More Like This

The RheumNow Week in Review - 20 October 2017

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses presentations from APLAR 2017 in Dubai, Catastrophic APS, safety of low-dose prednisone, frequency of psoriatic arthritis and a new drug for PsA and a hepatitis A outbreak in San Diego.

13 October 2017 The RheumNow Week in Review

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses a novel antiviral drug or the use of stem cell therapy for scleroderma, rituximab in HSP, when to withdraw NSAIDS in RA, and congrats to PAs and NPs!

The Big Need - NPs and PAs

Despite being one of the most satisfying of medical subspecialties, the number of U.S. rheumatologists is about to sharply decline.  These data were presented at the 2016 ACR meeting, where it was shown that the estimated total number of U.S. rheumatologists in in 2015 was 4,933 and is projected decrease to 3,645 by 2025. During this declining clinical supply, there will be a 138% increase in demand from 6,155 to 8,184 by 2030.

Arthritis Burden over $303 Billion Annually in U.S.

Arthritis of all types in the U.S. carried an economic burden of $303.5 billion in 2013, nearly 1% of the gross domestic product that year, according to a CDC analysis.

The RheumNow Week in Review - 6 October 2017

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. In this week's report, Dr. Jack Cush discusses when to hold the biologic, lymphoma risk with tofacitinib, early clues to the diagnosis of RA, biologic use in pregnancy, what's killing psoriasis patients and the 2016 top 5, best selling drugs in rheumatology.