AB0716 FIBROMYALGIA SYNDROME SEVERITY ACCORDING TO AGE CATEGORIES: RESULTS FROM A NATIONAL REGISTER
Authors: M. Di Carlo, S. Farah, L. Bazzichi, F. Atzeni, M. Govoni, G. Biasi, M. DI Franco, F. Mozzani, E. Gremese, L. Dagna, A. Batticciotto, F. Fischetti, R. Giacomelli, S. Guiducci, G. Guggino, M. Bentivegna, R. Gerli, C. Salvarani, G. Bajocchi, M. Ghini, F. Iannone, V. Giorgi, M. Cirillo, S. Bonazza, S. Barbagli, C. Gioia, N. G. Marino, A. Capacci, G. Cavalli, A. Cappelli, F. Carubbi, F. Nacci, R. Ilenia, M. Cutolo, L. Sinigaglia, P. Sarzi-Puttini, F. Salaffi
Journal: Annals of the Rheumatic Diseases (2021)

Background: Fibromyalgia syndrome (FM) is characterised by a complex symptom spectrum, dominated by the presence of chronic widespread pain, fatigue and unrefreshing sleep. FM affects between 2 and 3% of the general population. It is a condition that mainly involves middle-aged women, although it is increasingly being diagnosed in younger people. The severity of symptoms can vary greatly between individual patients, and is influenced by many factors (e.g. sex, body mass index) [1]. To date, there is little information about changes in severity in accordance with patient age. Objectives: The aim of this study was to investigate variations in symptom severity in FM patients according to age categories. Methods: A cross-sectional study of adult FM patients diagnosed according to the American College of Rheumatology 2010/2011 criteria was performed. The case series was included from an Italian national registry [2]. Patients were grouped according to five age categories: 18-40 years, 41-50 years, 51-60 years, 61-70 years, over 71 years. Symptom severity was assessed through the revised Fibromyalgia Impact Questionnaire (FIQR) and domains, including FIQR physical function (items 1-9), FIQR health status (items 10-11), and FIQR symptoms (items 12-21). Between-group characteristics were analysed using one-way analysis of variance (ANOVA). Results: This study included a total of 2889 patients, 403 aged 18-40 years, 756 aged 40-50 years, 1035 aged 50-60 years, 528 aged 60-70 years, and 167 over 70 years, respectively. The mean (standard deviation [SD]) score of the total FIQR was 52.68 (11.82). Total FIQR and individual domains all showed a normal distribution. Analysing the data by age category, there were statistically significant differences between the categories for the total FIQR (p = 0.030). The age categories with the highest disease severity were those above 71 years (FIQR 62.14, SD 22.45), and between 51-60 years (FIQR 60.31, SD 22.89) (Table 1). Significant differences between age categories were also found for the domains physical function (p = 0.006) and health status (p = 0.012), but not for the domain symptoms (p = 0.164). Table 1. Mean values of FIQR total score and domains according to age categories. FIQR and domains 18-40 years 41-50 years 51-60 years 61-70 years ≥71 years p* FIQR total, mean (SD) 57.90 (21.76) 59.25 (23.30) 60.31 (22.89) 57.13 (23.59) 62.14 (22.45) 0.030 FIQR physical function, mean (SD) 15.51 (7.56) 16.44 (7.77) 16.77 (7.51) 15.96 (7.82) 17.68 (7.26) 0.006 FIQR health status, mean (SD) 11.19 (5.85) 11.24 (5.99) 11.49 (5.93) 10.57 (6.11) 12.21 (5.97) 0.012 FIQR symptoms, mean (SD) 31.32 (10.48) 31.56 (11.32) 32.10 (11.01) 30.68 (11.47) 32.24 (11.34) 0.164 Abbreviations and legend. FIQR = revised Fibromyalgia Impact Questionnaire; SD = standard deviation; * = one-way analysis of variance (ANOVA). Conclusion: Distinguishing the disease severity in FM patients according to age categories, a bimodal distribution emerges, with the disease severity being greatest in patients over 71 years and in the 51-60 years decade. The main differences in severity, according to what can be detected through the FIQR, are attributable to the domains physical function and health status, which show higher scores in the two classes with higher severity. References: [1]Sarzi-Puttini P et al., Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol 2020; 16: 645–660. [2]Salaffi F et al., The Italian Fibromyalgia Registry: a new way of using routine real-world data concerning patient-reported disease status in healthcare research and clinical practice. Clin Exp Rheumatol 2020; Suppl 123: 65-71. Acknowledgements: Società Italiana di Reumatologia (SIR) and Italian Ministry of Health Disclosure of Interests: None declared