0:04
Hi, this is Bella Ma from RheumNow reporting from ACR26.
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I came across an interesting abstract, abstract number 0616.
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What it's trying to do is figure out if patients with RA who also have fibromyalgia — are there certain things that can help us find these patients who have additional pain or additional symptoms which are consistent with fibromyalgia.
0:31
So the fibromyalgia 1990 criteria is much more restrictive than the 2016 criteria.
0:38
So more patients are now getting diagnosed because of the slightly more relaxed criteria.
0:45
What these investigators did was try to figure out if making a — or finding a difference between tender joint minus swollen joint — if that helps us distinguish or find these patients.
1:01
So back in the day there was a study looking at this threshold of tender minus swollen joints, and it was seven.
1:08
If there are seven joints which are more tender than just the swollen joints, that seemed to be something that can help figure out if patients have fibromyalgia.
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So they now used the 2016 criteria and tried to figure out what the difference is in the tender and swollen joint count.
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When they did that, around 7% more patients were diagnosed with fibromyalgia using the slightly broader criteria.
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So it was 22% with the 1990 criteria versus 29% with the 2016 criteria.
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And again, these are all RA patients who have an additional diagnosis of fibromyalgia with the new criteria.
1:52
They also found that when the threshold of four — you know, tender minus swollen joint count — where the threshold of four was applied, the sensitivity increased from 71 to 76.
2:05
But the specificity did go down from around 0.7 to around 0.58.
2:15
So what it tells me is that we all know that when somebody has many many tender joints there's a high likelihood of central pain
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or fibromyalgia or one of those things, but this study gives you a rough estimate — a rough thing that you can go off —
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saying if there's more than a four-joint difference in count, so tender minus swollen, you sort of want to think if there is another component
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to it.
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Is this a definite checkpoint? Absolutely not.
2:44
But it's something to help you start thinking about this.
2:49
I think it's important for clinicians to take home that a four-joint count threshold — which is more tender than swollen — is helpful to find other pain syndromes including fibromyalgia.
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With that, signing off, this is Bella Ma on RheumNow.
3:11
Follow us more on Twitter @Bella_Ma. Thank you.
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