EFFECT OF PREGABALIN ON THE EFFICACY OF TREATMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS ASSOCIATED WITH FIBROMYALGIA
Summary. To evaluate the effect of neuromodulator pregabalin on the efficacy of treatment in patients with rheumatoid arthritis associated with fibromyalgia (RAFM). In the 12-week study were involved 90 patients with RA (100% female, average age 50.8±12.1 years). 46 patients had fibromyalgia. All patients received treatment with MTX (10–15 mg per week), low dose glucocorticoids (≤10 mg prednisone) and non-steroidal anti-inflammatory drugs. Part of the patients with fibromyalgia (24 of 46 patients) received neuromodulator pregabalin (150 mg 2 times a day). The efficacy of treatment was assessed after 12 weeks of therapy by the dynamics of clinical and laboratory markers of RA activity (DAS28, CDAI), patients’ functional capacity (HAQ) and the percentage of responders defined the criteria ACR20, ACR50, ACR70. Main treatment in patients with RA and FM resulted in regression of inflammation (number of swollen joints, ESR, CRP which decreased by 25.2, 22.5 and 39.3%, respectively, p <0.05), but not provided effective pain reduction and clinical disease activity by DAS28, CDAI and HAQ. After 12 weeks of treatment of RA patients without FM 52.3 was found; 15.9; 6.8% responders for ACR20, ACR50 and ACR70, and among patients with RAFM — only 22.7; 4.5 and 0.0% (p<0.05). Pregabalin significantly increased the efficacy of therapy in patients with RAFM: induced reduction in DAS28, CDAI and HAQ (19.2, 32.2 and 31.2%) and significantly increased the chances to reach the level of ACR20 (OR 4.39; 95% CI 1.27–15.3) through 12 weeks. Fibromyalgia in patients with RA is an independent predictor of resistance to treatment. Pregabalin reduces the severity of pain and significantly increases the effectiveness of treatment in patients with RA associated with FM.
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