LAUSR

Objectives To evaluate the symptom of headache as being able to clinically distinguish associated secondary fibromyalgia in patients with spondyloarthropathies (SpA). To compare the incidence of MSK complaints (related to SpA) in patients with headache to those that did not. To assess headache during the SpA disease course. Methods Registry data from 776 patients seen in clinic with SpA were analysed with reference to headache as symptom at presentation. The data of those patients presented with headache were compared with data of those patients who did not report headache with regards to demographics and disease characteristics. In addition, other MSK complaints, fatigue and pain during disease course were also analysed. Results From a total of 776 patients (m: f=265:508) age 48.3 ( SD +14.1), 13 were excluded as no answer was recorded. 117/ 763 patients (15.08%) representing 28 males and 89 females (23.9% vs 76.1% ratio 1:3.1) reported headache at disease onset. During the disease course, 13 patients out of the initial 117 did not record an answer to the question and were excluded. From remaining 104 patients, 95 patients (91.3%) continued to describe headache as a symptom. From those not reporting headache as initial symptom, (n=659) 148 did not record an answer and were excluded. From the remaining 511 patients, 194 (37.9%) reported headache during the disease course. On the data obtained from these 2 sub-groups, comparison took place using paired sample t-test. Table shows demographics and disease characteristics as well as differences between the 2 SpA sub-groups. Those presenting with headache describe worse disease, more fatigue and a greater percentage describe pain at pressure points and MSK system. Headache at presentation No headache at presentation Statistical significance CI (n=117) (n=656) (p) Age (mean ± SD) 47.7 (13.16) 48.3 (14.3) 0.1 -5.757 to 0.912 Gender (M:F) ratio 28:89 (1:3.1) 219:419 (1:1.9) 0.3 -0.025 to 0.077 Disease duration (y) (mean ± SD) 11.4 (12.1) 10.9 (10.8) 0.4 -1.905 to 4.470 Delay in diagnosis (y) (mean ± SD) 6.43 (8.9) 6.3 (8.1) 0.7 -3.151 to 2.151 ESR (mean ± SD) mmHg 15.5 (14.8) 18.2 (18) 0.07 -11.064 to 0.582 CRP (mean ± SD) mg/dL 10.4 (36) 8.2 (9.8) 0.4 -6.106 to 12.536 BASDAI score (mean ± SD) 7.31 (3.7) 6.06 (2.08) <0.005 0.783 to 2.624 BASFI score (mean ± SD) 5.6 (2.7) 5.04 (2.7) 0.09 -0.143 to 1.626 Buttock pain (%) 31.6 12.8 0.001 0.083 to 0.293 Back pain (%) 82.9 58.8 <0.005 0.125 to 0.337 Neck pain (%) 72.6 24.4 <0.005 0.340 to 0.583 Knee pain (%) 63.2 30.6 <0.005 0.284 to 0.520 Shoulder (%) 70.9 23 <0.005 0.312 to 0.559 Foot (%) 57.2 22 <0.005 0.279 to 0.524 Hip (%) 55.5 19.9 <0.005 0.217 to 0.467 Eye (%) 23 4.3 <0.005 0.102 to 0.274 Fatigue 77/116 (66.4%) 340/608 (55.9%) 0.018 0.029 to 0.299 Pain with pressure 71/117 (61.2%) 257/807 (42.4%) 0.000 0.122 to 0.378 Headache as co-morbidity 95 (109) 87.2% 195/509 (38.3%) 0.000 0.808 to 0.935 Conclusions Headache can clinically represent secondary FM among SpA patients. A proportion of patients (representing 15%) report headache at presentation. The majority of those patients (>90%) continue to describe headache during the disease course. From those patients who did not have headache at presentation, 38% report headache during the disease course. Patients describing headache at presentation have more MSK complaints at presentation. Disclosure of Interest None declared