Fibromyalgia at the ACR 2015 Meeting in San Francisco / Miscellanea

As I cannot discuss all studies presented at the ACR 2015 Annual Meeting in San Francisco, I have selected a few more without a context – miscellanea.

Robert S. Katz and colleagues presented an observational study: “Patients Who Take Many Medications for Their Fibromyalgia Symptoms at the Initial Office Visit Tend to Have a Worse Clinical Course”. Conclusion: “Those patients taking more prescription for their fibromyalgia symptoms at their initial office visit tended to have a worse clinical course, evidenced by higher HAQ scores, poor general health, and more pain and fatigue.” I guess all rheumatologists treating fibromyalgia can agree to these findings. Now, we’d like to know, what’s behind this observation. My guess is: a different way of coping, patients in this group might be classified as being passive, avoiding, externalizing, alexithymic.

Thomas Romano presented a study (?): “Correlation of Magnesium Levels and IGF-! Levels in Fibromyalgia Patients”. Background/Purpose: “To determine if there is a correlation between RBC Mg levels and IGF-! levels in Fibromyalgia (FM) patients”. “All [patients] fulfilled ACR 1990 Criteria for FM.” Conclusion: “There was a statistically significant positive correlation between IGF-1 levels and RBC Mg levels in the 60 FM patients studied. This has implications for treatment and further diagnostic testing.” Maybe there is a correlation, so what? And maybe it’s time to use the new ACR criteria. For sure it’s a bold statement that this correlation of (unnecessary?) lab tests of selected patients should have implications for treatment and further diagnostic testing.

Low IGF-1 levels in fibromyalgia patients have already been shown in 1992; please refer to the study by RM Bennett and colleagues; somatomedin C has been renamed IGF-1. So, again I must say: nothing new under the sun.

Daniel Kim and colleagues addressed weather in their study: “Evaluating Weather’s Effect on Fibromyalgia Patients Using the Revised Fibromyalgia Impact Questionnaire and the Brief Pain Inventory”. They used a broad set of parameters, but the authors “did not find any statistically significant effect of weather on fibromyalgia symptoms”. It’s like a pendulum. We know from our patients that weather changes and rainy, humid, cold weather conditions are attributed with increased pain and other symptoms of fibromyalgia (as well as inflammatory rheumatic diseases!), but as strange as it may seem, stressable scientific proof is yet to come. I hope that research on this topic will go on.

Lin Ge and colleagues looked at: “Association of Smoking and Cognitive Function in Patients with Fibromyalgia”. Conclusion: “The results of this study indicate that smokers with FM report worse cognitive function. Although the cause-effect relationship between smoking and cognition is unclear, clinicians who care for patients with FM should be aware of this association.” I think, I’ll take this study and others to look more closely at the diseases we treat and the effects of smoking. Some studies are congruent with these findings, others are not. I guess we all agree that smoking isn’t healthy and may worsen symptoms and make treatment less effective. Concerning cognitive function there seems to be a link to Alzheimer’s and dementia per se.

References:

Katz RS, Katz Small A, Leavitt H. Patients Who Take Many Medications for Their Fibromyalgia Symptoms at the Initial Office Visit Tend to Have a Worse Clinical Course [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/patients-who-take-many-medications-for-their-fibromyalgia-symptoms-at-the-initial-office-visit-tend-to-have-a-worse-clinical-course/. Accessed November 12, 2015.

Romano T. Correlation of Magnesium Levels and IGF-! Levels in Fibromyalgia Patients [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/correlation-of-magnesium-levels-and-igf-levels-in-fibromyalgia-patients/. Accessed November 12, 2015.

Bennett RM, Clark SR, Campbell SM, Burckhardt CS: Low levels of somatomedin C in patients with the fibromyalgia syndrome. A possible link between sleep and muscle pain. Arthritis Rheum. 1992 Oct;35(10):1113-6. PMID: 1418002. http://www.ncbi.nlm.nih.gov/pubmed/1418002.

Kim D, Chan R, Plans M, Hackshaw K. Evaluating Weather’s Effect on Fibromyalgia Patients Using the Revised Fibromyalgia Impact Questionnaire and the Brief Pain Inventory [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/evaluating-weathers-effect-on-fibromyalgia-patients-using-the-revised-fibromyalgia-impact-questionnaire-and-the-brief-pain-inventory/. Accessed November 12, 2015.

Ge L, Oh TH, Vincent A, Mohabbat A, Jiang L, Whipple M, McAllister S, Wang Z, Qu W. Association of Smoking and Cognitive Function in Patients with Fibromyalgia [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/association-of-smoking-and-cognitive-function-in-patients-with-fibromyalgia/. Accessed November 12, 2015.

Fibromyalgia and smoking: http://rheumatologe.blogspot.de/2011/11/fibromyalgia-and-smoking.html