**Disclosure statement**

I currently work as an independent medical biotechnical consultant, and in the past, have consulted for Crescendo Bioscience. and Pfizer.

on the DAS28 in 56 RA patients followed prospectively for 1 year. "After adjusting for age, gender, disease duration and baseline tender joint count and patient global assessment respectively, higher levels of depression and anxiety at baseline were associated with increased tender joint count and patient global assessment scores at

Recognize Comorbid Fibromyalgia Syndrome in Order to Better Evaluate Selected Rheumatic…

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[4] Wolfe F. The relation between tender points and fibromyalgia symptom variables: Evidence that fibromyalgia is not a discrete disorder. Annals of the Rheumatic Disorders.

[5] Atzeni F, Cazzola M, Benucci M, et al. Chronic widespread pain in the spectrum of rheumatological diseases. Best Practice Research and Clinic Rheumatology. 2011;**25**:165-171. FMS (1990 ACR) is often associated with other diseases that act as confounding and aggravating factors, including primary Sjögren's syndrome (pSS), systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). It has been reported to coexist in 25% of patients with RA, 30% of patients with SLE and 50% of patients with pSS. It is associ-

[6] Haliloglu S, Carlioglu A, Akdeiz D, et al. Fibromyalgia in patients with other rheumatic diseases: Prevalence and relationship with disease activity. Rheumatology Introduction. 2014;**34**:1275-1280. The prevalence of FMS in patients with rheumatologic diseases was found to be 6.6% for RA, 13.4% for SLE, 12.6% for AS, 10.1% for OA, 5.7% for BD, 7.1% for FMF, 12% for SS, 25% for vasculitis, 1.4% for gout, and 6.9% for PMR. Increased pain, physical limitations, and fatigue may be interpreted as increased activity of these diseases, and a common treatment option is the prescription of higher doses of biologic

[7] El-Rabbat SM, Mahmoud NK, Gheita TA. Clinical significance of fibromyalgia syndrome in different rheumatic diseases: Relation to disease activity and quality of life. Reumatology Clinical. April 11, 2017. Pii: S1699-258X(17)30048-7. Doi: 10.1016/j. reuma.2017.02.008. [Epub ahead of print]. 160 patients (50 RA, 50 SLE, 30 SSc and 30 BD) and matched corresponding healthy controls were included. Disease activity was assessed using disease activity score in 28 joints (DAS28) for RA, SLE Disease Activity index (SLEDAI), modified Rodnan skin score for SSc and BD Current Activity Form (BDCAF). The QoL was also recorded. In the RA, SLE, SSc and BD patients, FMS was found in 14, 18, 6.67 and 3.33% respectively compared to 2.1, 3, 3.3 and 0% in their corresponding controls. In RA DAS was significantly higher and Quol lower. In SLE the

[8] Roussou E, Ciurtin C. Clinical overlap between fibromyalgia tender points and enthesitis sites in patients with spondyloarthritis who present with inflammatory back pain.

[9] Croft P, Rigby AS, Boswell R, et al. The prevalence of chronic widespread pain in the

[10] Wessely S, Nimnuan C, Sharpe M. Functional somatic syndromes: One or many? Lancet.

Clinical and Experimenal Rheumatology. 2012;**30**(Suppl 74):24-30

general population. Journal of Rheumatology. 1993;**20**:710-713

1-year follow-up."

1997;**56**:268-271

ated with diminished QoL

agents or corticosteroids

1999;**354**:936-939

SSscale of the PSD correlated with the SLEDAI
