Effectiveness of venlafaxine in patients with ankylosing spondylitis with a neuropathic component of the pain syndrome

Abstract

Annotation. In aim to study the effectiveness of the use of venlafaxine in the complex therapy of ankylosing spondylitis in the presence of neuropathic pain, the results of treatment of 131 patients with ankylosing spondylitis were studied: 88 patients without neuropathic pain, 22 patients with neuropathic pain who received standard treatment, and 21 patients with neuropathic pain who received venlafaxine in addition to standard therapy. Statistical analysis of differences in quantitative features was performed using the non-parametric Mann-Whitney test, categorized using Fisher's exact test (one-sided) at p<0.05. Significantly better dynamics in the course of treatment were found in patients with neuropathic pain treated with venlafaxine compared to patients with neuropathic pain and without neuropathic pain treated with standard therapy. ASAS20 compliance was achieved in 31.8% of patients without neuropathic pain and in 13.6% of patients with neuropathic pain who received standard therapy and in 47.6% of patients with neuropathic pain who received venlafaxine in addition to standard therapy. The calculation of the odds ratio proved that the presence of neuropathic pain increases the risk of resistance to treatment (failure to achieve ASAS20 by almost three times (odds ratio 2.95; confidence interval 0.8-10.8). Prescribing venlafaxine to patients with ankylosing spondylitis and the presence of neuropathic pain increases the chances of achieving ASAS20 by 5.75 times with a confidence interval of 1.3-25.5 (p<0.05). Patients who received venlafaxine in addition to standard therapy achieved significantly better scores on BASMI, ASAS, HAQ, depression and reactive anxiety after 12-week therapy. This gives reasons to recommend the introduction of venlafaxine to the treatment regimen of AS in the presence of neuropathic pain