News & Views | Published:


Neurobiological similarities between RA and fibromyalgia

Nature Reviews Rheumatologyvolume 14pages324325 (2018) | Download Citation

Pain management can be a difficult problem for patients with rheumatoid arthritis (RA), some of whom can experience pain similar to that reported by patients with fibromyalgia. Now, advanced imaging techniques are revealing neurobiological alterations in patients with RA that mirror those seen in fibromyalgia, hinting at new treatment possibilities.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. 1.

    Smolen, J. S. et al. Rheumatoid arthritis. Nat. Rev. Dis. Primers 4, 18001 (2018).

  2. 2.

    Atzeni, F. et al. Pain in systemic inflammatory rheumatic diseases. Best Pract. Res. Clin. Rheumatol. 29, 42–52 (2015).

  3. 3.

    Phillips, K. & Clauw, D. J. Central pain mechanisms in the rheumatic diseases: future directions. Arthritis Rheum. 65, 291–302 (2013).

  4. 4.

    Basu, N. et al. Neurobiological features of fibromyalgia are also present among rheumatoid arthritis patients. Arthritis Rheumatol. (2018).

  5. 5.

    Lee, Y. C. et al. Pain persists in DAS28 rheumatoid arthritis remission but not in ACR/EULAR remission: a longitudinal observational study. Arthritis Res. Ther. 13, R83 (2011).

  6. 6.

    Clauw, D. J. Fibromyalgia: a clinical review. JAMA 311, 1547–1555 (2014).

  7. 7.

    Ichesco, E. et al. Altered resting state connectivity of the insular cortex in individuals with fibromyalgia. J. Pain 15, 815–826.e1 (2014).

  8. 8.

    Grijalva, C. G. et al. Changing patterns of medication use in patients with rheumatoid arthritis in a Medicaid population. Rheumatology 47, 1061–1064 (2008).

  9. 9.

    Rech, J. et al. Association of brain functional magnetic resonance activity with response to tumor necrosis factor inhibition in rheumatoid arthritis. Arthritis Rheum. 65, 325–333 (2013).

  10. 10.

    Macfarlane, G. J. et al. EULAR revised recommendations for the management of fibromyalgia. Ann. Rheum. Dis. 76, 318–328 (2017).

Download references


The authors would like to thank K. Smart for help in preparing the text for this article.

Author information


  1. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

    • Fabiola Atzeni
  2. Department of Rheumatology, ASST Fatebenefratelli-Sacco, Milan, Italy

    • Piercarlo Sarzi-Puttini


  1. Search for Fabiola Atzeni in:

  2. Search for Piercarlo Sarzi-Puttini in:

Competing interests

The authors declare that they have no competing interests.

Corresponding author

Correspondence to Piercarlo Sarzi-Puttini.

About this article

Publication history



Newsletter Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing