Contribution of inflammation markers and quantitative sensory testing (QST) indices of central sensitisation to rheumatoid arthritis pain.

Autor: Georgopoulos V; Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK. vasileios.georgopoulos@nottingham.ac.uk.; Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK. vasileios.georgopoulos@nottingham.ac.uk.; NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK. vasileios.georgopoulos@nottingham.ac.uk.; Clinical Sciences Building, A25 Academic Rheumatology, City Hospital, Nottingham, NG51PB, UK. vasileios.georgopoulos@nottingham.ac.uk., Smith S; Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.; Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK.; NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK., McWilliams DF; Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.; Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK.; NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK., Ferguson E; Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK.; School of Psychology, University of Nottingham, Nottingham, UK., Wakefield R; Leeds Institute of Rheumatic and Musculoskeletal Medicine and NIHR Leeds Biomedical Research Centre, University of Leeds, Leeds, UK., Platts D; Independent Consultant, Nottingham, UK., Ledbury S; Independent Consultant, Nottingham, UK., Wilson D; Rheumatology, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK., Walsh DA; Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK.; Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK.; NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK.; Rheumatology, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK.
Jazyk: angličtina
Zdroj: Arthritis research & therapy [Arthritis Res Ther] 2024 Oct 08; Vol. 26 (1), pp. 175. Date of Electronic Publication: 2024 Oct 08.
DOI: 10.1186/s13075-024-03407-5
Abstrakt: Background: Pain, the primary complaint in rheumatoid arthritis (RA), is multifaceted, and may be driven by inflammatory disease activity and central sensitisation. We aimed to ascertain what proportion of RA pain severity is explained by markers of inflammation and quantitative sensory testing (QST) indices of central sensitisation.
Methods: This was a cross-sectional analysis of data from individuals with clinically active RA. Pain severity was assessed using numerical rating scales and inflammation via 28-joint Disease Activity Score (DAS28) and Ultrasound (Greyscale, Power Doppler). Pain sensitivity was assessed by 'static' (tibialis anterior or brachioradialis pressure pain detection threshold-PPT-TA/PPT-BR) and 'dynamic' (temporal summation-TS, conditioned pain modulation-CPM) QST. Bivariate associations used Spearman's correlation coefficients, and multivariable linear regression models determined relative contributions to pain severity.
Results: In bivariate analyses of N = 96 (age 65 ± 10y, 77% females) people with RA, pain severity was significantly associated with inflammation indices (r = 0.20 to 0.55), and CPM (r=-0.26). In multivariable models that included TS, CPM, age, sex, and body mass index, inflammation indices remained significantly associated with pain severity. Multivariable models explained 22 to 27% of pain variance. Heterogeneity was apparent for associations with pain between subscores for pain now, strongest or average over the past 4-weeks.
Conclusions: In individuals with clinically active RA, markers of inflammatory disease activity best explain RA pain with only marginal contributions from QST indices of central sensitisation. Although inflammation plays a key role in the experience of RA pain, the greater proportion of pain severity remains unexplained by DAS28 and ultrasound indices of inflammation.
(© 2024. The Author(s).)
Databáze: MEDLINE
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