Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Longitudinal Assessment of Fibromyalgia in Young Adults Previously Diagnosed with Juvenile Fibromyalgia.
Ting1, Tracy V., Strotman1, Daniel, Verkamp1, Emily, Desai1, Anjali, Lynch-Jordan1, Anne, Arnold2, Lesley M., Kashikar-Zuck1, Susmita
At present, little is known about the prognosis for children and adolescents diagnosed with Juvenile Fibromyalgia (JFM). As part of a longitudinal assessment of outcomes in adolescents with JFM compared with healthy controls, we are collecting data about fibromyalgia (FM) symptoms as they transition into the young adult years. The objective of this study was to determine how many of the JFM patients and controls meet criteria for FM over time using 3 approaches to the diagnosis of FM: the 1990 American College of Rheumatology (ACR) criteria [Wolfe F et al. Arthritis Rheum 1990], the 2010 ACR criteria [Wolfe F et al. Arthritis Rheum 2010], and a questionnaire for FM developed by Pope and Hudson [Pope HG, Hudson JI. Int J Psychiatry Med 1991]. Another goal was to assess the sensitivity and specificity of the 2010 ACR criteria and the Pope-Hudson questionnaire in this population using the 1990 ACR criteria as the gold standard.
Participants were recruited approximately 4 years from initial participation and asked to complete a survey that contained the 2010 ACR criteria self-report questionnaire and the Pope-Hudson questionnaire. The 1990 ACR criteria were determined by an in-person evaluation by a trained research staff member. Demographic information, chi-square analysis and sensitivity and specificity calculations were performed.
Forty-two young adults with a previous diagnosis of JFM and 20 healthy controls were recruited. The group included 98.4% females, average age = 22.6 years, 87.1% Caucasian. The JFM group was more likely to have FM based on all 3 criteria. FM was identified in 69% (N=29), 71.4% (N=30), and 88.1% (N=37) of the JFM group according to the 2010 ACR, Pope-Hudson and 1990 ACR criteria respectively. Only the Pope-Hudson questionnaire revealed FM among 20% (N=4) of controls, while neither the 2010 nor 1990 ACR criteria identified FM among controls. Using the 1990 ACR Criteria as the gold standard for the diagnosis of FM, the sensitivity and specificity of the 2010 ACR criteria was 76% and 96% respectively and Pope-Hudson questionnaire was 76% for both.
This study reports ongoing findings from the first controlled longitudinal study to explore the persistence of FM symptoms in a cohort of JFM patients and their healthy counterparts. The results indicate that a substantial number of JFM patients have persistence of FM through the transitional young adult years; therefore continued close follow-up and treatment may be warranted. In addition, both the 2010 ACR criteria and the Pope-Hudson questionnaire demonstrated good sensitivity and specificity in identifying FM using the 1990 ACR criteria as the gold standard, with greater specificity using the 2010 ACR criteria.
To cite this abstract, please use the following information:
Ting, Tracy V., Strotman, Daniel, Verkamp, Emily, Desai, Anjali, Lynch-Jordan, Anne, Arnold, Lesley M., et al; Longitudinal Assessment of Fibromyalgia in Young Adults Previously Diagnosed with Juvenile Fibromyalgia. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :940