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
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