Use of the 2010 ACR fibromyalgia diagnostic criteria to identify long-term outcomes in patients with juvenile-onset fibromyalgia

      Juvenile-onset Fibromyalgia (JFM) is a chronic widespread musculoskeletal pain condition with multiple associated symptoms including sleep difficulty and fatigue. Little is known about the course of JFM and whether symptoms persist into adulthood. In an ongoing longitudinal study of adolescents with JFM, we found that the majority (>70%) of patients reported ongoing pain and associated symptoms in late adolescence (Mage = 19 years). The current study aimed to determine how many JFM patients continued to meet criteria for active fibromyalgia (FM) in their young adult years, and how many experienced sub-clinical symptoms, or were pain-free. The most recent 2010 American College of Rheumatology (ACR) criteria for classification of adult FM was used to define active FM. At initial assessment, JFM patients (n=85; Mage = 15.29, SD = .47) were assessed for fibromyalgia per Yunus and Masi (1985) criteria. At an approximately 7-year follow-up, patients (Mage = 21.73, SD = 2.04) completed the Widespread Pain Index and Symptom Severity questionnaire online and a standard 18-count tender point examination was conducted by an examiner at an in-person visit. Results indicated that 39 patients (45.9%) met the 2010 ACR fibromyalgia diagnostic criteria and had at least 11 out of 18 tender points, 32 patients (37.6%) had sub-clinical symptoms but no longer met diagnostic criteria, and approximately 16% (n = 14) of patients reported they were pain free. Comparing those who met criteria for active FM and those that were improved, patients with ongoing FM had significantly higher anxiety, depression, and functional disability. Overall, the majority of patients initially diagnosed with JFM in adolescence continue to experience fibromyalgia or associated symptoms (83.5%) into young adulthood. Early and effective interventions are needed to improve long-term outcomes for patients with JFM. Funded by NIAMS Grant R01 AR054842-01A2.