Non-nociceptive pain in rheumatoid arthritis is frequent and affects disease activity estimation: cross-sectional data from the FRAME study

A W Christensen; Signe Rifbjerg-Madsen; R Christensen; L Dreyer; H Tillingsøe; S Seven; M Boesen; K Ellegaard; H Bliddal; B Danneskiold-Samsøe; K Amris

doi:10.3109/03009742.2016.1139174

Non-nociceptive pain in rheumatoid arthritis is frequent and affects disease activity estimation: cross-sectional data from the FRAME study

A W Christensen, Signe Rifbjerg-Madsen, R Christensen, L Dreyer, H Tillingsøe, S Seven, M Boesen, K Ellegaard, H Bliddal, B Danneskiold-Samsøe, K Amris

Institut for Klinisk Medicin

21 Citationer (Scopus)

Abstract

BACKGROUND: The painDETECT questionnaire (PDQ) is a mechanism-based pain classification tool assigning patients to one of three categories depending on the quality of the experienced pain. Patients with non-nociceptive pain score high on the PDQ. The objective was to assess the proportions of the three PDQ classification groups in patients with rheumatoid arthritis (RA) and to explore differences in clinical characteristics.

METHOD: RA patients initiating or escalating their RA therapy were included prospectively and underwent a thorough examination programme. Low (PDQ score < 13), medium (PDQ score 13-18), and high (PDQ score > 18) scores indicate nociceptive, unclear/possible neuropathic, or neuropathic pain mechanisms, respectively.

RESULTS: The 102 included patients were classified into the following PDQ classification groups: low = 65%, medium = 23%, and high = 12%. Patients in the medium and high PDQ groups scored worse on indicators of anxiety, depression, disability, mental health-related quality of life, pain, and fatigue. They also had more tender points and an RA disease activity score based on 28 joints (DAS28) where a higher fraction of the composite score pertained to non-inflammatory factors compared to patients in the low PDQ classification group. There were no differences in objective inflammatory indices across groups. Multiple regression analysis demonstrated that the tender joint count (TJC) and the 36-item Short Form Health Survey (SF36) mental component summary (MCS) score were independently associated with the PDQ score.

CONCLUSIONS: In patients initiating or intensifying medical treatment for their RA, non-nociceptive pain (PDQ score ≥ 13) is common. In these patients, the pain mechanisms result in increased disease activity scores on a non-inflammatory basis.

Originalsprog	Engelsk
Tidsskrift	Scandinavian Journal of Rheumatology
Vol/bind	45
Udgave nummer	6
Sider (fra-til)	461-469
Antal sider	9
ISSN	0300-9742
DOI	https://doi.org/10.3109/03009742.2016.1139174
Status	Udgivet - 1 nov. 2016

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10.3109/03009742.2016.1139174

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Christensen, A. W., Rifbjerg-Madsen, S., Christensen, R., Dreyer, L., Tillingsøe, H., Seven, S., Boesen, M., Ellegaard, K., Bliddal, H., Danneskiold-Samsøe, B., & Amris, K. (2016). Non-nociceptive pain in rheumatoid arthritis is frequent and affects disease activity estimation: cross-sectional data from the FRAME study. Scandinavian Journal of Rheumatology, 45(6), 461-469. https://doi.org/10.3109/03009742.2016.1139174

Non-nociceptive pain in rheumatoid arthritis is frequent and affects disease activity estimation : cross-sectional data from the FRAME study. / Christensen, A W; Rifbjerg-Madsen, Signe; Christensen, R et al.

I: Scandinavian Journal of Rheumatology, Bind 45, Nr. 6, 01.11.2016, s. 461-469.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Christensen, AW, Rifbjerg-Madsen, S, Christensen, R, Dreyer, L, Tillingsøe, H, Seven, S, Boesen, M, Ellegaard, K, Bliddal, H, Danneskiold-Samsøe, B & Amris, K 2016, 'Non-nociceptive pain in rheumatoid arthritis is frequent and affects disease activity estimation: cross-sectional data from the FRAME study', Scandinavian Journal of Rheumatology, bind 45, nr. 6, s. 461-469. https://doi.org/10.3109/03009742.2016.1139174

@article{f17e416b8f164e838809ce47a15d0273,

title = "Non-nociceptive pain in rheumatoid arthritis is frequent and affects disease activity estimation: cross-sectional data from the FRAME study",

abstract = "BACKGROUND: The painDETECT questionnaire (PDQ) is a mechanism-based pain classification tool assigning patients to one of three categories depending on the quality of the experienced pain. Patients with non-nociceptive pain score high on the PDQ. The objective was to assess the proportions of the three PDQ classification groups in patients with rheumatoid arthritis (RA) and to explore differences in clinical characteristics.METHOD: RA patients initiating or escalating their RA therapy were included prospectively and underwent a thorough examination programme. Low (PDQ score < 13), medium (PDQ score 13-18), and high (PDQ score > 18) scores indicate nociceptive, unclear/possible neuropathic, or neuropathic pain mechanisms, respectively.RESULTS: The 102 included patients were classified into the following PDQ classification groups: low = 65%, medium = 23%, and high = 12%. Patients in the medium and high PDQ groups scored worse on indicators of anxiety, depression, disability, mental health-related quality of life, pain, and fatigue. They also had more tender points and an RA disease activity score based on 28 joints (DAS28) where a higher fraction of the composite score pertained to non-inflammatory factors compared to patients in the low PDQ classification group. There were no differences in objective inflammatory indices across groups. Multiple regression analysis demonstrated that the tender joint count (TJC) and the 36-item Short Form Health Survey (SF36) mental component summary (MCS) score were independently associated with the PDQ score.CONCLUSIONS: In patients initiating or intensifying medical treatment for their RA, non-nociceptive pain (PDQ score ≥ 13) is common. In these patients, the pain mechanisms result in increased disease activity scores on a non-inflammatory basis.",

keywords = "Adult, Aged, Arthritis, Rheumatoid, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Nociception, Pain, Pain Measurement, Regression Analysis, Severity of Illness Index, Journal Article",

author = "Christensen, {A W} and Signe Rifbjerg-Madsen and R Christensen and L Dreyer and H Tillings{\o}e and S Seven and M Boesen and K Ellegaard and H Bliddal and B Danneskiold-Sams{\o}e and K Amris",

year = "2016",

month = nov,

day = "1",

doi = "10.3109/03009742.2016.1139174",

language = "English",

volume = "45",

pages = "461--469",

journal = "Scandinavian Journal of Rheumatology",

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publisher = "Taylor & Francis",

number = "6",

}

TY - JOUR

T1 - Non-nociceptive pain in rheumatoid arthritis is frequent and affects disease activity estimation

T2 - cross-sectional data from the FRAME study

AU - Christensen, A W

AU - Rifbjerg-Madsen, Signe

AU - Christensen, R

AU - Dreyer, L

AU - Tillingsøe, H

AU - Seven, S

AU - Boesen, M

AU - Ellegaard, K

AU - Bliddal, H

AU - Danneskiold-Samsøe, B

AU - Amris, K

PY - 2016/11/1

Y1 - 2016/11/1

N2 - BACKGROUND: The painDETECT questionnaire (PDQ) is a mechanism-based pain classification tool assigning patients to one of three categories depending on the quality of the experienced pain. Patients with non-nociceptive pain score high on the PDQ. The objective was to assess the proportions of the three PDQ classification groups in patients with rheumatoid arthritis (RA) and to explore differences in clinical characteristics.METHOD: RA patients initiating or escalating their RA therapy were included prospectively and underwent a thorough examination programme. Low (PDQ score < 13), medium (PDQ score 13-18), and high (PDQ score > 18) scores indicate nociceptive, unclear/possible neuropathic, or neuropathic pain mechanisms, respectively.RESULTS: The 102 included patients were classified into the following PDQ classification groups: low = 65%, medium = 23%, and high = 12%. Patients in the medium and high PDQ groups scored worse on indicators of anxiety, depression, disability, mental health-related quality of life, pain, and fatigue. They also had more tender points and an RA disease activity score based on 28 joints (DAS28) where a higher fraction of the composite score pertained to non-inflammatory factors compared to patients in the low PDQ classification group. There were no differences in objective inflammatory indices across groups. Multiple regression analysis demonstrated that the tender joint count (TJC) and the 36-item Short Form Health Survey (SF36) mental component summary (MCS) score were independently associated with the PDQ score.CONCLUSIONS: In patients initiating or intensifying medical treatment for their RA, non-nociceptive pain (PDQ score ≥ 13) is common. In these patients, the pain mechanisms result in increased disease activity scores on a non-inflammatory basis.

AB - BACKGROUND: The painDETECT questionnaire (PDQ) is a mechanism-based pain classification tool assigning patients to one of three categories depending on the quality of the experienced pain. Patients with non-nociceptive pain score high on the PDQ. The objective was to assess the proportions of the three PDQ classification groups in patients with rheumatoid arthritis (RA) and to explore differences in clinical characteristics.METHOD: RA patients initiating or escalating their RA therapy were included prospectively and underwent a thorough examination programme. Low (PDQ score < 13), medium (PDQ score 13-18), and high (PDQ score > 18) scores indicate nociceptive, unclear/possible neuropathic, or neuropathic pain mechanisms, respectively.RESULTS: The 102 included patients were classified into the following PDQ classification groups: low = 65%, medium = 23%, and high = 12%. Patients in the medium and high PDQ groups scored worse on indicators of anxiety, depression, disability, mental health-related quality of life, pain, and fatigue. They also had more tender points and an RA disease activity score based on 28 joints (DAS28) where a higher fraction of the composite score pertained to non-inflammatory factors compared to patients in the low PDQ classification group. There were no differences in objective inflammatory indices across groups. Multiple regression analysis demonstrated that the tender joint count (TJC) and the 36-item Short Form Health Survey (SF36) mental component summary (MCS) score were independently associated with the PDQ score.CONCLUSIONS: In patients initiating or intensifying medical treatment for their RA, non-nociceptive pain (PDQ score ≥ 13) is common. In these patients, the pain mechanisms result in increased disease activity scores on a non-inflammatory basis.

KW - Adult

KW - Aged

KW - Arthritis, Rheumatoid

KW - Cross-Sectional Studies

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Nociception

KW - Pain

KW - Pain Measurement

KW - Regression Analysis

KW - Severity of Illness Index

KW - Journal Article

U2 - 10.3109/03009742.2016.1139174

DO - 10.3109/03009742.2016.1139174

M3 - Journal article

C2 - 26987470

SN - 0300-9742

VL - 45

SP - 461

EP - 469

JO - Scandinavian Journal of Rheumatology

JF - Scandinavian Journal of Rheumatology

IS - 6

ER -

Non-nociceptive pain in rheumatoid arthritis is frequent and affects disease activity estimation: cross-sectional data from the FRAME study

Abstract

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