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Pain in rheumatoid arthritis: a seven-year follow-up study of pain distribution and factors associated with transition from and to chronic widespread pain
Scandinavian Journal of Rheumatology ( IF 2.2 ) Pub Date : 2021-09-01 , DOI: 10.1080/03009742.2021.1944304
Mle Andersson 1, 2 , B Svensson 1 , S Bergman 1, 2, 3
Affiliation  

Objective

To study transitions from and to chronic widespread pain (CWP) over 7 years in patients with rheumatoid arthritis (RA).

Method

Two postal questionnaires were sent to patients included in the BARFOT (Better Anti-Rheumatic Pharmacotherapy) study, the first in 2010 and the second in 2017. The questionnaires assessed pain, number of tender and swollen joints, functional disability, health-related quality of life (HRQoL), pharmacological treatment, lifestyle factors, and patient-reported body mass index (BMI). The responders to both questionnaires were divided into three groups according to the reported pain duration and distribution: patients having no chronic pain (NCP), chronic regional pain (CRP), and CWP.

Results

In all, 953 patients answered the questionnaires at both time-points. One-third (324) of the patients reported CWP in 2010, and 140 (43%) of the patients had transition to NCP or CRP in 2017. In multivariate logistic regression models, adjusting for age, gender, and disease duration, transition from CWP was associated with normal BMI, fewer tender joints, less pain, less fatigue, fewer pain regions, less disability, better HRQoL, and biologic treatment. In 2010, 628 patients reported NCP or CRP, whereas 114 of them reported CWP in 2017. Transition to CWP was associated with female gender, obesity, more tender and swollen joints, higher pain-related variables, worse disability, and worse HRQoL.

Conclusion

There are modifiable factors associated with transitions from and to CWP that could be identified. Paying attention to these factors could improve pain treatment in the management of RA.



中文翻译:

类风湿性关节炎疼痛:疼痛分布和与慢性广泛性疼痛转变相关因素的七年随访研究

客观的

研究类风湿关节炎 (RA) 患者在 7 年内从和向慢性广泛性疼痛 (CWP) 的转变。

方法

向参与 BARFOT(更好的抗风湿药物治疗)研究的患者发送了两份邮寄问卷,第一份在 2010 年,第二份在 2017 年。问卷评估了疼痛、关节触痛和肿胀的数量、功能障碍、健康相关质量生活(HRQoL)、药物治疗、生活方式因素和患者报告的体重指数(BMI)。根据报告的疼痛持续时间和分布,将两份问卷的应答者分为三组:无慢性疼痛(NCP)、慢性局部疼痛(CRP)和CWP。

结果

总共有 953 名患者在两个时间点回答了问卷。2010 年有三分之一 (324) 的患者报告了 CWP,2017 年有 140 名 (43%) 的患者过渡到 NCP 或 CRP。在多变量逻辑回归模型中,调整了年龄、性别和疾病持续时间,从CWP 与正常 BMI、更少的压痛关节、更少的疼痛、更少的疲劳、更少的疼痛区域、更少的残疾、更好的 HRQoL 和生物治疗相关。2010 年,628 名患者报告了 NCP 或 CRP,而其中 114 名患者在 2017 年报告了 CWP。过渡到 CWP 与女性、肥胖、关节更柔软和肿胀、疼痛相关变量更高、残疾更严重和 HRQoL 更差有关。

结论

可以确定与从和到 CWP 的转换相关的可修改因素。关注这些因素可以改善 RA 管理中的疼痛治疗。

更新日期:2021-09-01
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