A new study on the use of Vectra disease activity test in patients with fibromyalgia entitled “Elevated Serum Leptin Concentrations in a Subset of Fibromyalgia Patients with High Inflammatory Markers” was presented at the American College of Rheumatology Annual Meeting in 2014 by Dr. Anne Quismorio at Covina Arthritis, along with colleagues.
Fibromyalgia (FM) occurs approximately in 2% to 8% of the population, is characterized by widespread pain, and is normally accompanied by fatigue, memory problems, and sleep disturbances. Fibromyalgia (FM) has been described as a heterogeneous condition with differences in biological variables including elevated sedimentation rate (ESR), cytokine profile, and hormone levels. These different variables my characterize subgroups within FM population, but this has still to be established. The diagnosis of FM is mainly clinical and specific biomarkers for this condition have until now not been identified. In rheumatoid arthritis (RA), the Vectra®DA, a multi-biomarker disease activity score, was validated to measure disease activity and is commercially available test to measure serum concentrations of twelve biomarkers.
In this study, the research team used the Vectra®DA to measure serum biomarkers in patients with fibromyalgia and elevated inflammatory markers. This was a cross-sectional, prospective study of 33 patients from Los Angeles County. The average age of the patients was 43.5 years, with more females (94%) than males (6%). The patients met the 2010 ACR classification criteria for FM and had elevated ESR and/or C-reactive protein (CRP). The patients did not have clinical evidence of RA or other systemic rheumatic disease. The results obtained with Vectra®DA were high in patients, with mean score of 46.5 (range 30 to 84, or moderate to high activity). The serum concentrations of the 12 biomarkers, such as IL-6 and CRP, except for leptin, were similar to the ones observed for RA patients. Among the FM patients, 45% had higher leptin levels, ranging from 30 to 81 ng/mL, than the ones reported in RA, ranging from 1 to 45 ng/mL. The FM patients had an average of leptin levels of 42.3 ng/mL. The CRP levels but not ESR was positively associated with the Vectra®DA score.
The researchers characterized a subgroup of FM patients with elevated ESR and/or CRP. The high Vectra®DA scores supported the idea of an inflammatory process associated to this subgroup of patients. In this subgroup the levels of leptin were higher, independent of body mass index (BMI), suggesting the influence of other variables besides obesity in this increase. They found that leptin seems to play an important pro-inflammatory and immunomodulatory role in the pathogenesis of this clinical subgroup of FM. Therefore, a better understanding of this clinical FM subgroup may lead to new diagnostic and therapeutic approaches in fibromyalgia.
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