Journal article
Predictors for severe persisting pain in rheumatoid arthritis are associated with pain origin and appraisal of pain
- Abstract:
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Objectives: To determine the proportion of rheumatoid arthritis (RA) patients with severe persisting pain and to identify predictive factors despite treatment-controlled disease activity.
Methods: This prospective multi-centre study included outpatients with RA scheduled for escalation of anti-inflammatory treatment due to active disease and severe pain (DAS28 > 3.2 and VAS > 50). At week 24, patients were stratified into reference group (DAS28 improvement > 1.2 or DAS28 ≤ 3.2 and VAS pain score < 50), non-responders (DAS28 improvement ≤ 1.2 and DAS28 > 3.2, regardless of VAS pain score), and persisting pain group (DAS28 improvement > 1.2 or DAS28 ≥ 3.2 and VAS pain score ≥ 50). The former two subgroups ended the study at week 24. The latter continued until week 48. Demographic data, DAS28-CRP, visual analogue scale for pain, painDETECT questionnaire (PD-Q) to identify neuropathic pain (NeP), and the Pain Catastrophizing Scale (PCS) were assessed and tested for relation to persisting pain.
Results: Of 567 patients, 337 (59.4%) were classified as reference group, 102 (18.0%) as nonresponders, and 128 (22.6%) as patients with persisting pain. 21 (8.8%) responders, 28 (35.0%) non-responders, and 27 (26.5%) persisting pain patients tested positive for NeP at week 24. Pain catastrophising (p=0.002) and number of tender joints (p=0.004) were positively associated with persisting pain at week 24. Baseline PD-Q was not related to subsequent persisting pain.
Conclusions: Persisting and non-nociceptive pain occur frequently in RA. Besides the potential involvement of NeP, pain catastrophising and a higher number of tender joints coincide with persisting pain.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 2.9MB, Terms of use)
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- Publisher copy:
- 10.1136/ard-2023-225414
- Publisher:
- BMJ Publishing Group
- Journal:
- Annals of the Rheumatic Diseases More from this journal
- Volume:
- 83
- Issue:
- 10
- Pages:
- 1381-1388
- Publication date:
- 2024-05-30
- Acceptance date:
- 2024-05-04
- DOI:
- EISSN:
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1468-2060
- ISSN:
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0003-4967
- Language:
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English
- Pubs id:
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1997545
- Local pid:
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pubs:1997545
- Deposit date:
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2024-05-20
Terms of use
- Copyright holder:
- Baerwald et al.
- Copyright date:
- 2024
- Rights statement:
- © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ on behalf of EULAR. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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