Información de la revista
Vol. 1. Núm. 4.
Páginas 200-210 (Noviembre - Diciembre 2005)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 1. Núm. 4.
Páginas 200-210 (Noviembre - Diciembre 2005)
Originales
Acceso a texto completo
¿Existe asociación entre la fibromialgia, el aumento de la comorbilidad por enfermedad neoplásica, cardiovascular e infecciones, y el de la mortalidad?
Is there an association between fibromyalgia and an increase in comorbidity: neoplastic and cardiovascular diseases, infections and mortality?
Visitas
19088
E. Chamizo-Carmona
Autor para correspondencia
eugeniochamizo@arrakis.es

Correspondencia: Dr. E. Chamizo-Carmona. Polígono Nueva Ciudad, s/n. 06800 Mérida. España.
Unidad de Reumatología. Hospital General de Mérida. España
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas
Objetivo

Conocer si la fibromialgia (FM) se asocial un aumento de comorbilidad del tipo infecciones y enfermedades neoplásicas y cardiovasculares, y a un aumento de la mortalidad.

Material y métodos

Revisión sistemática. Se seleccionaron, mediante una estrategia sensible, todos los estudios publicados en PubMed (desde 1961), Embase (desde 1991), Cochrane Library Plus y resúmenes de congresos de reumatología (ACR y EULAR, desde 1999) hasta mayo de 2005. Se incluyeron estudios de cohortes, descriptivos y comparativos. Se depuró el resultado de la búsqueda mediante revisión de los títulos y los resúmenes.

Resultados

De 562 referencias proporcionadas por la búsqueda, se seleccionaron 33 estudios potenciales. Los pacientes con FM refieren una mayor comorbilidad y utilización de recursos médicos que la población general y que los pacientes con otras enfermedades reumáticas. La FM es más frecuente en pacientes hospitalizados y en el seno de infecciones por el virus de la inmunodeficiencia humana (VIH) y el virus de la hepatitis C (VHC). Algunos estudios encuentran un riesgo elevado de desarrollar cáncer en pacientes con FM. Diversos estudios han encontrado una tasa aumentada de mortalidad en FM, principalmente por cáncer y suicidios.

Conclusiones

A pesar de la elevada comorbilidad y utilización de los recursos médicos expresados por los pacientes con FM, no hay evidencia de que la FM se asocie a un aumento de comorbilidad por enfermedades cardiovasculares o infecciones. La asociación entre FM e infección por VHC o VIH indica la existencia de una posible relación entre FM e infección viral crónica. Los pacientes con dolor crónico generalizado pueden tener un riesgo aumentado de desarrollar cáncer. Parece que la FM puede llevar asociado también un riesgo aumentado de muerte accidental y por cáncer.

Palabras clave:
Fibromialgia
Pronóstico
Comorbilidad
Cáncer
Infecciones
Enfermedad cardiovascular
Mortalidad
Objective

To determine whether fibromyalgia (FM) is associated with an increase in comorbidity (infections, neoplastic and cardiovascular disease) as well as with an increase in mortality.

Material and methods

We performed a systematic review. Using a sensitive search strategy, all studies published in PubMed (from 1961), Embase (from 1991), Cochrane Library Plus and abstracts of rheumatology congresses (ACR and EULAR, from 1999) until May 2005 were selected. Cohort, descriptive and comparative studies were selected. The results of the search were screened through a review of the titles and abstracts.

Results

Of the 562 references retrieved by the search, 33 potentially relevant studies were selected. Patients with FM showed greater comorbidity and medical resource use than did the general population and patients with other rheumatic diseases. FM was more frequent in hospitalized patients and in the context of HIV and hepatitis C infections. Some studies found a high risk of developing cancer in FM patients. Several studies found an increased mortality rate in FM, mainly due to cancer and suicide.

Conclusions

Despite the high comorbidity and medical resource use in FM, there is no evidence that this entity is associated with an increase in comborbidity due to cardiovascular disease or infections. The association between FM and HIV and hepatitis C virus infections suggests a possible relationship between FM and chronic viral infection. Patients with chronic generalized pain may have an increased risk of developing cancer. FM may also carry an increased risk of accidental death and death from cancer.

Key words:
Fibromyalgia
Prognosis
Comorbidity
Cancer
Infections
Cardiovascular disease
Mortality
El Texto completo está disponible en PDF
Bibliografía
[1.]
L. Neumann, D. Buskila.
Epidemiology of fibromyalgia.
Curr Pain Headache Rep, 7 (2003), pp. 362-368
[2.]
A.R. Jadad, R.A. Moore, D. Carroll, C. Jenkinson, D.J. Reynolds, D.J. Gavaghan, et al.
Assessing the quality of reports of randomized clinical trials: is blinding necessary?.
Control Clin Trials, 17 (1996), pp. 1-12
[3.]
A. Laupacis, G. Wells, W.S. Richardson, P. Tugwell.
User's guides to the medical literature. V. How to use an article about prognosis.
JAMA, 272 (1994), pp. 234-237
[4.]
F. Wolfe, D.J. Hawley.
Fibromyalgia in the adult Danish population.
Scand J Rheumatol, 23 (1994), pp. 55-56
[5.]
S.H. Wigers.
Fibromyalgia outcome: the predictive values of symptom duration, physical activity, disability pension, and critical life events–a 4.5 year prospective study.
J Psychosom Res, 41 (1996), pp. 235-243
[6.]
P. Croft, A.S. Rigby, R. Boswell, J. Schollum, A. Silman.
The prevalence of chronic widespread pain in the general population.
J Rheumatol, 20 (1993), pp. 710-713
[7.]
K.P. White, M. Speechley, M. Harth, T. Ostbye.
The London Fibromyalgia Epidemiology Study: the prevalence of fibromyalgia syndrome in London, Ontario.
J Rheumatol, 26 (1999), pp. 1570-1576
[8.]
K.O. Forseth, O. Forre, J.T. Gran.
A 5.5 year prospective study of self-reported musculoskeletal pain and of fibromyalgia in a female population: significance and natural history.
Clin Rheumatol, 18 (1999), pp. 114-121
[9.]
K.P. White, W.R. Nielson, M. Harth, T. Ostbye, M. Speechley.
Does the label “fibromyalgia” alter health status, function, and health service utilization? A prospective, within-group comparison in a community cohort of adults with chronic widespread pain.
Arthritis Rheum, 47 (2002), pp. 260-265
[10.]
A.M. Mengshoel, M. Haugen.
Health status in fibromyalgia–a followup study.
J Rheumatol, 28 (2001), pp. 2085-2089
[11.]
L.A. Aaron, D. Buchwald.
Chronic diffuse musculoskeletal pain, fibromyalgia and comorbid unexplained clinical conditions.
Best Pract Res Clin Rheumatol, 17 (2003), pp. 563-574
[12.]
M. Makela, M. Heliovaara.
Prevalence of primary fibromyalgia in the Finnish population.
BMJ, 303 (1991), pp. 216-219
[13.]
F. Wolfe, J. Anderson, D. Harkness, R.M. Bennett, X.J. Caro, D.L. Goldenberg, et al.
A prospective, longitudinal, multicenter study of service utilization and costs in fibromyalgia.
[14.]
F. Wolfe, D.J. Hawley.
Evidence of disordered symptom appraisal in fibromyalgia: increased rates of reported comorbidity and comorbidity severity.
Clin Exp Rheumatol, 17 (1999), pp. 297-303
[15.]
D. Buskila, L. Neumann, L.R. Odes, E. Schleifer, R. Depsames, M. Abu-Shakra.
The prevalence of musculoskeletal pain and fibromyalgia in patients hospitalized on internal medicine wards.
Semin Arthritis Rheum, 30 (2001), pp. 411-417
[16.]
G.J. Macfarlane, J. McBeth, A.J. Silman.
Widespread body pain and mortality: prospective population based study.
BMJ, 323 (2001), pp. 662-665
[17.]
J. McBeth, A.J. Silman, G.J. Macfarlane.
Association of widespread body pain with an increased risk of cancer and reduced cancer survival: a prospective, population-based study.
Arthritis Rheum, 48 (2003), pp. 1686-1692
[18.]
L. Dreyer, J.F. Winther, L. Mellenkjaer.
Cancer Incidence in fibromyalgia: a Danish cohort followed for 16 year [abstract].
EULAR, (2004),
[19.]
S. Bernatsky, P.L. Dobkin, M. De Civita, J.R. Penrod.
Co-morbidity and physician use in fibromyalgia.
Swiss Med Wkly, 135 (2005), pp. 76-81
[20.]
F. Wolfe, D.J. Hawley.
The long time outcomes of fibromyalgia: rates and predictors of mortality in fibromyalgia after 25 years of follow-up [abstract].
ACR, (1999),
[21.]
M. Pimentel, E.J. Chow, D. Hallegua, D. Wallace, H.C. Lin.
Small intestinal bacterial overgrowth: a possible association with fibromyalgia.
J Musculoskelet Pain, 9 (2001), pp. 107-113
[22.]
M. Pimentel, D. Wallace, D. Hallegua, E. Chow, Y. Kong, S. Park, et al.
A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing.
Ann Rheum Dis, 63 (2004), pp. 450-452
[23.]
A.M. Berg, S.J. Naides, R.W. Simms.
Established fibromyalgia syndrome and parvovirus B19 infection.
J Rheumatol, 20 (1993), pp. 1941-1943
[24.]
T. Rea, J. Russo, W. Katon, R.L. Ashley, D. Buchwald.
A prospective study of tender points and fibromyalgia during and after an acute viral infection.
Arch Intern Med, 159 (1999), pp. 865-870
[25.]
I.H. Wittrup, B. Jensen, H. Bliddal, B. Danneskiold-Samsoe, A. Wiik.
Comparison of viral antibodies in 2 groups of patients with fibromyalgia.
J Rheumatol, 28 (2001), pp. 601-603
[26.]
H. Dinerman, A.C. Steere.
Lyme disease associated with fibromyalgia.
Ann Intern Med, 117 (1992), pp. 281-285
[27.]
D. Buskila, D.D. Gladman, P. Langevitz, S. Urowitz, H.A. Smythe.
Fibromyalgia in human immunodeficiency virus infection.
J Rheumatol, 17 (1990), pp. 1202-1206
[28.]
R.W. Simms, C.A. Zerbini, N. Ferrante, J. Anthony, D.T. Felson, D.E. Craven.
Fibromyalgia syndrome in patients infected with human immunodeficiency virus. The Boston City Hospital Clinical AIDS Team.
Am J Med, 92 (1992), pp. 368-374
[29.]
D. Buskila, A. Shnaider, L. Neumann, D. Zilberman, N. Hilzenrat, E. Sikuler.
Fibromyalgia in hepatitis C virus infection. Another infectious disease relationship.
Arch Intern Med, 157 (1997), pp. 2497-2500
[30.]
C. Goulding, P. O’Connell, F.E. Murray.
Prevalence of fibromyalgia, anxiety and depression in chronic hepatitis C virus infection: relationship to RT-PCR status and mode of acquisition.
Eur J Gastroenterol Hepatol, 13 (2001), pp. 507-511
[31.]
J. Rivera, A. De Diego, M. Trinchet, A. García Monforte.
Fibromyalgia-associated hepatitis C virus infection.
Br J Rheumatol, 36 (1997), pp. 981-985
[32.]
L. Dreyer.
Increased suicide, liver disease and cerebrovascular disease mortality in a cohort of Danish patients with fibromyalgia followed for 16 year [abstract].
EULAR, (2004),
Copyright © 2005. Elsevier España S.L. Barcelona
Idiomas
Reumatología Clínica
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?