Fibromyalgia as a cause of uncontrolled asthma: a case–control multicenter study

Abstract

Background: Fibromyalgia can affect the control of asthma when both diseases are present in a single patient.

Objectives: To characterize asthma in patients with concomitant fibromyalgia to assess whether fibromyalgia is an independent factor of asthma severity that influences poor asthma control. We also evaluated how dyspnea is perceived by patients in order to demonstrate that alterations in the perception of airway obstruction may be responsible for poor asthma control.

Methods: This was a cross-sectional case–control multicenter study, in which 56 patients in the asthma and fibromyalgia group were matched to 36 asthmatics by sex, approximate age, and asthma severity level. All patients were women. Study variables included the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), the Nijmegen hyperventilation syndrome questionnaire, the Hospital Anxiety and Depression Scale, and perception of dyspnea after acute bronchoconstriction.

Results: Although patients in both study groups showed similar asthma severity and use of anti-asthmatic drugs, patients in the asthma and fibromyalgia group showed lower scores on the ACT and MiniAQLQ questionnaires, and higher scores of anxiety and depression as well as hyperventilation compared to asthma patients without fibromyalgia. All these differences were statistically significant.

Conclusions: Fibromyalgia in patients with asthma influences poor control of the respiratory disease and is associated with altered perception of dyspnea, hyperventilation syndrome, high prevalence of depression and anxiety, and impaired quality of life.

Clinical implications: Fibromyalgia may be considered a risk factor for uncontrolled asthma in patients suffering from asthma and fibromyalgia concomitantly.

Keywords:

• Asthma
• hyperventilation syndrome
• fibromyalgia
• dyspnea
• asthma control

Transparency

Declaration of funding

This work was funded in part with a grant from Fundación de Neumologia de la Comunidad Valenciana (FNCV 2012).

Author contributions: EMM and VP conceived of the study, participated in its design and performed the statistical analysis. IT coordinated the study and performed the database. E.M.M. drafted the manuscript. S.Q. and V.P. helped to draft the manuscript. All authors included patients in research, provided writing assistance, read and approved the final manuscript.

Declaration of financial/other relationships

E.M.M. has disclosed that she has received honoraria for speaking at sponsored meetings from AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Mundipharma and Pfizer. V.P. has disclosed that she/he has received honoraria for speaking at sponsored meetings from AstraZeneca, Boehringer-Ingelheim, Chiesi, GlaxoSmithKline, Merck, Mundipharma and Pfizer; and as a consultant for Mundipharma, Orion and Teva; received travel assistance from Boehringer-Ingelheim and Chiesi; and received funding/grant support for research projects from a variety of government agencies and not-for-profit foundations, as well as Chiesi, Menarini and Merck. A.R. has disclosed that she has participated as speaker and researcher in field asthma meetings supported by GSK and conferences sponsored by Mundipharma and Novartis. S.Q. has disclosed that he has been on advisory boards for and has received speaker’s honoraria from AstraZeneca, GlaxoSmithKline, Novartis, Mundipharma, Teva, ALK, Stallergenes, Allergy Therapeutics, Chiesi and Pfizer. A.M.F. has disclosed that she has received honoraria for speaking at sponsored meetings, travel assistance or funding/grant support for research projects from Almirall, AstraZeneca, Boehringer-Ingelheim, Esteve Laboratories, GlaxoSmithKline, Novartis and Boston Scientific in the past three years. P.C. has disclosed that she has participated in clinical trials supported by GSK. I.T., I.U., X.C., B.H., M.B.A., J.D. and C.S. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

The authors thank Marta Pulido MD for editing the manuscript and editorial assistance.