Around 1 in 8 patients with axial spondyloarthritis (axSpA) also meet criteria for fibromyalgia and such patients have considerable unmet need. Identifying effective therapy is important but to what extent fibromyalgia-like symptoms relate to axSpA disease severity has not been established. The aim of the current analysis was to determine whether distinct clusters of axSpA patients exist and if so to determine a) whether they differ in terms of prevalence of fibromyalgia and b) the features of patients in clusters with high prevalence. The British Society for Rheumatology Biologics Register (BSRBR-AS) recruited axSpA patients from 83 centres 2012–2017. Clinical data, and information from patients was collected (including research criteria for fibromyalgia). Cluster analysis was undertaken using split samples for development and validation both in the whole population and the sub-group which met fibromyalgia criteria. One thousand three hundred thirty-eight participants were included of whom 23% met research criteria for fibromyalgia. Four clusters were identified. Two exhibited very high disease activity, one which was primarily axial (n = 347) and a smaller cluster (n = 32) with axial and peripheral disease, and in both groups more than half of members met criteria for fibromyalgia. The remaining two clusters (n = 437, n = 462) had overall less severe disease however the one which showed greater disease activity and poorer quality of life had a higher proportion meeting fibromyalgia criteria (16% v. 4%). Within those meeting fibromyalgia criteria there were three clusters. The two main groups were defined by level of symptom severity with a smaller third cluster noted to have high average swollen and tender joint counts and high levels of comorbidity. The major feature defining clusters with a high proportion of persons meeting criteria for fibromyalgia is high axSpA disease activity although clusters with features of fibromyalgia in the absence of high disease activity also show moderately high prevalence. Management may be most successful with pharmacologic therapy to target inflammation but enhanced by the concurrent use of non-pharmacologic therapy in such patients.

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也符合纤维肌痛标准的 AxSpA 患者：使用来自英国国家登记册 (BSRBR-AS) 的数据识别不同的患者群

大约八分之一的轴型脊柱关节炎 (axSpA) 患者也符合纤维肌痛的标准，这些患者有相当多的未满足需求。确定有效的治疗方法很重要，但纤维肌痛样症状与 axSpA 疾病严重程度的相关程度尚未确定。当前分析的目的是确定是否存在不同的 axSpA 患者群，如果存在，则确定 a) 它们在纤维肌痛的患病率方面是否不同，以及 b) 高患病率群中患者的特征。英国风湿病学会生物制剂登记 (BSRBR-AS) 从 2012-2017 年的 83 个中心招募了 axSpA 患者。收集临床数据和患者信息（包括纤维肌痛的研究标准）。使用分割样本进行聚类分析，以在整个人群和符合纤维肌痛标准的亚组中进行开发和验证。包括 1338 名参与者，其中 23% 符合纤维肌痛的研究标准。确定了四个集群。两个表现出非常高的疾病活动性，一个主要是轴性（n = 347）和一个较小的集群（n = 32）患有轴性和外周疾病，并且在两组中超过一半的成员符合纤维肌痛的标准。其余两个集群（n = 437，n = 462）的疾病总体上不太严重，但表现出更大的疾病活动性和较差的生活质量的集群具有更高的比例符合纤维肌痛标准（16% 对 4%）。在符合纤维肌痛标准的那些中有三个集群。两个主要组由症状严重程度定义，其中较小的第三组具有较高的平均肿胀和压痛关节计数以及较高的合并症水平。符合纤维肌痛标准的高比例人群的主要特征是高 axSpA 疾病活动性，尽管在没有高疾病活动性的情况下具有纤维肌痛特征的集群也显示出中度高患病率。靶向炎症的药物治疗可能最成功，但在此类患者中同时使用非药物治疗可增强治疗效果。符合纤维肌痛标准的高比例人群的主要特征是高 axSpA 疾病活动性，尽管在没有高疾病活动性的情况下具有纤维肌痛特征的集群也显示出中度高患病率。靶向炎症的药物治疗可能最成功，但在此类患者中同时使用非药物治疗可增强治疗效果。符合纤维肌痛标准的高比例人群的主要特征是高 axSpA 疾病活动性，尽管在没有高疾病活动性的情况下具有纤维肌痛特征的集群也显示出中度高患病率。靶向炎症的药物治疗可能最成功，但在此类患者中同时使用非药物治疗可增强治疗效果。