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A diagnosis of rheumatoid arthritis, endometriosis or IBD is associated with later onset of fibromyalgia and chronic widespread pain

Larrosa Pardo, F LU ; Bondesson, E LU ; Schelin, M E C LU and Jöud, A LU (2019) In European Journal of Pain
Abstract

BACKGROUND: Widespread pain is a common comorbidity in several chronic diseases and is suspected to be caused by the underlying disease that has provoked a state of central sensitization. However, this argument is currently limited by evidence that has not sufficiently captured the temporal nature of the relationship between diagnosis of the underlying disease and onset of widespread pain. The aim of this study was to investigate whether patients with rheumatoid arthritis (RA), endometriosis or inflammatory bowel disease (IBD) have a higher risk of developing widespread pain (fibromyalgia or chronic widespread pain [CWP]).

METHODS: Using the Swedish Skåne Healthcare Register of healthcare consultation, a cohort of 889,938 adult... (More)

BACKGROUND: Widespread pain is a common comorbidity in several chronic diseases and is suspected to be caused by the underlying disease that has provoked a state of central sensitization. However, this argument is currently limited by evidence that has not sufficiently captured the temporal nature of the relationship between diagnosis of the underlying disease and onset of widespread pain. The aim of this study was to investigate whether patients with rheumatoid arthritis (RA), endometriosis or inflammatory bowel disease (IBD) have a higher risk of developing widespread pain (fibromyalgia or chronic widespread pain [CWP]).

METHODS: Using the Swedish Skåne Healthcare Register of healthcare consultation, a cohort of 889,938 adult patients were followed from 2007-2016, and incident cases of RA, endometriosis or IBD and of fibromyalgia and CWP were identified by registered diagnoses. Using Poisson regression, we calculated incidence rate ratios (IRR) adjusted for sex, age, education, and propensity to seek health care.

RESULTS: For patients with RA, the IRR for later fibromyalgia was 3.64 (95% CI: 2.75-4.81) compared to patients without RA, and for CWP the figure was 2.96 (95% CI: 1.81-4.86). For endometriosis patients, the IRR for fibromyalgia was 2.83 (95% CI: 1.96-4.08) and for CWP 5.02 (95% CI: 3.10-8.13). IRR for IBD patients was 2.32 (95% CI: 1.58-3.42) for fibromyalgia and 1.42 (95% CI: 0.93-2.17) for CWP.

CONCLUSIONS: This study shows that RA, endometriosis and IBD are all risk factors for later fibromyalgia and chronic widespread pain, consistent with a hypothesis of central sensitization as an effect of a painful underlying condition.

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author
organization
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Contribution to journal
publication status
epub
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in
European Journal of Pain
publisher
Elsevier
external identifiers
  • scopus:85067661360
ISSN
1090-3801
DOI
10.1002/ejp.1432
language
English
LU publication?
yes
id
39753c24-faa4-40ee-a7e3-4d34979b62e3
date added to LUP
2019-06-14 14:10:22
date last changed
2019-07-30 05:03:46
@article{39753c24-faa4-40ee-a7e3-4d34979b62e3,
  abstract     = {<p>BACKGROUND: Widespread pain is a common comorbidity in several chronic diseases and is suspected to be caused by the underlying disease that has provoked a state of central sensitization. However, this argument is currently limited by evidence that has not sufficiently captured the temporal nature of the relationship between diagnosis of the underlying disease and onset of widespread pain. The aim of this study was to investigate whether patients with rheumatoid arthritis (RA), endometriosis or inflammatory bowel disease (IBD) have a higher risk of developing widespread pain (fibromyalgia or chronic widespread pain [CWP]).</p><p>METHODS: Using the Swedish Skåne Healthcare Register of healthcare consultation, a cohort of 889,938 adult patients were followed from 2007-2016, and incident cases of RA, endometriosis or IBD and of fibromyalgia and CWP were identified by registered diagnoses. Using Poisson regression, we calculated incidence rate ratios (IRR) adjusted for sex, age, education, and propensity to seek health care.</p><p>RESULTS: For patients with RA, the IRR for later fibromyalgia was 3.64 (95% CI: 2.75-4.81) compared to patients without RA, and for CWP the figure was 2.96 (95% CI: 1.81-4.86). For endometriosis patients, the IRR for fibromyalgia was 2.83 (95% CI: 1.96-4.08) and for CWP 5.02 (95% CI: 3.10-8.13). IRR for IBD patients was 2.32 (95% CI: 1.58-3.42) for fibromyalgia and 1.42 (95% CI: 0.93-2.17) for CWP.</p><p>CONCLUSIONS: This study shows that RA, endometriosis and IBD are all risk factors for later fibromyalgia and chronic widespread pain, consistent with a hypothesis of central sensitization as an effect of a painful underlying condition.</p>},
  author       = {Larrosa Pardo, F and Bondesson, E and Schelin, M E C and Jöud, A},
  issn         = {1090-3801},
  language     = {eng},
  month        = {05},
  publisher    = {Elsevier},
  series       = {European Journal of Pain},
  title        = {A diagnosis of rheumatoid arthritis, endometriosis or IBD is associated with later onset of fibromyalgia and chronic widespread pain},
  url          = {http://dx.doi.org/10.1002/ejp.1432},
  year         = {2019},
}