P0375 Fibromyalgia as a predictive factor of fatigue and reduced quality of life in patients with inflammatory bowel disease
Authors: Prado R D C P , Domiciano D S , Mattos P S L D , Linhares F D S , Azevedo M F C D , Carlos A D S , Damião A O M C , Barros L L 
Published: January 2025

Abstract

Background
Inflammatory bowel disease (IBD) patients often experience extraintestinal manifestations, which significantly impact their quality of life, contribute to disability, and impose substantial costs on healthcare systems. Osteoarticular manifestations are the most common type of EIMs. Fibromyalgia (FM), the second most common rheumatic disease, affects an estimated 2% to 8% of the global population, with a higher prevalence among females. FM is characterized by widespread pain, frequently accompanied by fatigue, cognitive difficulties, and sleep disturbances. Evidence indicates a strong association between FM and IBD, with numerous studies reporting a higher prevalence of FM among IBD patients compared to the general population.

Methods
The aim of this study was to evaluate the prevalence of FM in patients with IBD. We conducted a cross-sectional analysis at our IBD outpatient clinic from July 2023 to July 2024, including patients aged over 18 years. The diagnosis of FM was made based on the criteria established by the American College of Rheumatology in 2016. Data on demographics, IBD phenotype, clinical and endoscopic activity, quality of life (IBDQ) and fatigue (FACIT) measurements were recorded.

Results
A total of 250 patients were included. The overall prevalence of FM was 15.2%, predominantly in females (53.6%) (p &lt; 0.001). The mean age at the time of inclusion was 34.5 years (SD 15.3) and the mean disease duration was 10.9 years (SD 8.1). Most patients in our cohort were White (55.7%) and non-smokers (65.3%). There was no significant difference in C-reactive protein levels between IBD-FM patients and IBD-only patients (5.1 vs. 8.6 mg/dL; p = 0.324). Patients with ulcerative colitis exhibited a higher frequency of FM compared to those with Crohn’s disease (22 vs 16, p = 0.041). Patients with FM were statistically older (40.7 years vs. 33.4 years; p = 0.008) and had a higher BMI (27.8 vs. 24.8; p = 0.001) compared to those without FM. Additionally, patients with FM had a significantly longer mean disease duration (14 years vs 10.3, p = 0.015) and reported notably lower mean scores of IBDQ (147.4 vs 183.1; p &lt; 0,001) and lower mean FACIT scores (31.5 vs 42.1; p &lt; 0,001) compared to patients without FM.

Conclusion
The association between FM and IBD was substantial in the studied cohort, with a prevalence exceeding that reported in the general population and in previous literature. There was a slight predominance of FM among female patients diagnosed with UC. The co-occurrence of IBD and FM was associated with a significantly reduced quality of life and elevated levels of fatigue.

References
1.Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RL, Mease PJ, Russell AS, Russell IJ, Walitt B. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016 Dec;46(3):319-329.
2.Kocyigit BF, Akyol A. Fibromyalgia syndrome: epidemiology, diagnosis and treatment. Reumatologia. 2022;60(6):413-421.
3.Martinis F, Tinazzi I, Bertolini E, Citriniti G, Variola A, Geccherle A, Marchetta A, McGonagle D, Macchioni P. Clinical and sonographic discrimination between fibromyalgia and spondyloarthopathy in inflammatory bowel disease with musculoskeletal pain. Rheumatology (Oxford). 2020 Oct 1;59(10):2857-2863.