How can we effectively manage patients who have axial spondyloarthritis and fibromyalgia?

Disease - Ankylosing spondylitis, fibromyalgia

Lead applicant - Professor Gary Macfarlane

Organisation - University of Aberdeen

Type of grant - Clinical Studies

Status of grant - Active

Amount of the original award - £184,561.20

Start date - 1 June 2017

Reference - 21378

Public Summary

What are the aims of this research?

Axial spondyloarthritis is a painful condition that mainly affects the spine and pelvic joints, causing chronic lower back pain and stiffness. It can occur together with the long-term condition fibromyalgia, which causes widespread pain and tiredness, but the rate of this combination is unknown. The FOMAxS study aims to identify if the occurrence of axial spondyloarthritis and fibromyalgia is sufficiently common to develop a clinical trial that would look to effectively manage patients with both conditions using a cognitive behavioural therapy (CBT) programme.

Why is this research important?

When these two conditions occur together, it can be difficult to know whether symptoms, such as pain, result from the inflammation in axial spondyloarthritis or specifically from the fibromyalgia. This means that it is not always clear what the best form of treatment is, and can result in inappropriate treatment plans.

CBT is a talking therapy successfully used to help some people with fibromyalgia. This project looks to assess whether this therapy may help people who have both axial spondyloarthritis and fibromyalgia, along with the best care available for axial spondyloarthritis. The researchers will survey people with axial spondyloarthritis to assess how many have the condition in combination with fibromyalgia. If this combination is common, the researchers will offer a short course of telephone CBT to see whether people with combined diagnoses, or axial spondyloarthritis only, find this therapy acceptable and useful. If successful then CBT could help to prevent fibromyalgia symptoms, rather than just treating them when they occur, as it would provide patients with the training to deal with future flare ups.

How will the findings benefit patients?

Findings from this preliminary research will determine whether a future clinical trial should be undertaken to see if CBT, in addition to best available care for axial spondyloarthritis, results in better quality of life for people who have both axial spondyloarthritis and fibromyalgia. Research in this area could help to reduce the use of biologic therapies, which often come with unwanted side effects, when the condition doesn’t require it. Additionally, any benefit observed may also be relevant for patients who have other inflammatory conditions, such as rheumatoid arthritis, when they occur together with fibromyalgia.