Neuropathic pain in spondyloarthritis: Decoding its prevalence, risk factors, and impact on disease activity

IF 4.6 2区医学 Q1 RHEUMATOLOGY Seminars in arthritis and rheumatism Pub Date : 2024-09-27 DOI:10.1016/j.semarthrit.2024.152557

Giuseppe Lopalco , Sergio Del Vescovo , Maria Morrone , Andrea Cito , Marco Fornaro , Eugenio Capparelli , Eneida Cela , Maria Sole Chimenti , Florenzo Iannone

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Abstract

Objectives

This study aimed to evaluate the prevalence and characteristics of neuropathic pain in patients with various subtypes of spondyloarthritis (SpA), including axial SpA (axSpA), psoriatic arthritis (PsA), and undifferentiated peripheral SpA (p-SpA). Additionally, the study sought to identify potential risk factors associated with the presence or severity of neuropathic pain and to investigate its impact on clinical disease activity assessment.

Methods

We conducted a cross-sectional study at two tertiary rheumatology centers, enrolling patients diagnosed with SpA. Data on demographic and clinical characteristics, comorbidities, and current therapies were collected. Neuropathic pain was assessed using the PainDETECT Questionnaire (PD-Q) and the Neuropathic Pain Symptom Inventory (NPSI). Statistical analyses included descriptive statistics, t-tests, and Pearson's correlations to evaluate the relationships between neuropathic pain scores and clinical disease activity indices.

Results

The study included 177 patients. Of these, 22.2% had a PD-Q score ≥19, showing a high likelihood of neuropathic pain, while 64.9% scored ≤12, suggesting the absence of significant neuropathic components. The mean PD-Q score was 11.5 ± 10.1. Subgroup analyses showed that females had significantly higher scores for paroxysmal and evoked pain (p < 0.05), and obese patients had significantly higher scores across all NPSI subscores (p < 0.05). Moderate positive correlations were found between neuropathic pain scores and clinical disease activity indices, such as DAPSA (r = 0.46, p < 0.0001) and ASDAS-CRP (r = 0.42, p < 0.01).

Conclusions

Neuropathic pain is prevalent among patients with SpA and is significantly associated with disease activity assessments and management. This study highlights the importance of integrating neuropathic pain evaluation into the clinical assessment of SpA to tailor treatment approaches effectively and improve patient outcomes.

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脊柱关节炎的神经性疼痛：解码脊柱关节炎神经痛的发病率、风险因素及其对疾病活动的影响。

研究目的本研究旨在评估脊柱关节炎（SpA）各种亚型患者中神经病理性疼痛的患病率和特征，包括轴性脊柱关节炎（axSpA）、银屑病关节炎（PsA）和未分化外周性脊柱关节炎（p-SpA）。此外，该研究还试图找出与神经病理性疼痛的存在或严重程度相关的潜在风险因素，并调查其对临床疾病活动性评估的影响：我们在两家三级风湿病学中心开展了一项横断面研究，招募了确诊为 SpA 的患者。我们收集了有关人口统计学和临床特征、合并症和当前疗法的数据。神经病理性疼痛采用疼痛DETECT问卷（PD-Q）和神经病理性疼痛症状量表（NPSI）进行评估。统计分析包括描述性统计、t 检验和皮尔逊相关性，以评估神经病理性疼痛评分与临床疾病活动指数之间的关系：研究共纳入 177 名患者。其中22.2%的患者PD-Q评分≥19分，显示神经病理性疼痛的可能性很高，而64.9%的患者评分≤12分，表明没有明显的神经病理性成分。PD-Q平均得分为11.5 ± 10.1。亚组分析显示，女性阵发性疼痛和诱发痛的得分明显更高（P < 0.05），肥胖患者在所有 NPSI 子评分中的得分明显更高（P < 0.05）。神经病理性疼痛评分与临床疾病活动指数（如 DAPSA（r = 0.46，p < 0.0001）和 ASDAS-CRP（r = 0.42，p < 0.01））之间呈中度正相关：神经性疼痛在 SpA 患者中很普遍，与疾病活动性评估和管理密切相关。这项研究强调了将神经性疼痛评估纳入SpA临床评估的重要性，以便有效地调整治疗方法，改善患者预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.