Neuropathic pain in ankylosing spondylitis: a meta-analysis

Neuropathic pain in rheumatoid arthritis

“…Частота невропатических дескрипторов при РА варьирует в пределах 17-36% [8][9][10]. Что касается других ревматических заболеваний, то, например, при остеоартрите их частота составляет 30-66% [11][12][13][14], при анкилозирующем спондилите -13-33,5% [15,16]. Невропатические дескрипторы боли отмечаются у большинства пациентов с фибромиалгией [17,18].…”

Somatosensory dysfunction related neuropathic pain component affects disease activity, functional status and quality of life in ankylosing spondylitis

“…Although anti‐inflammatory drugs suppress inflammation in MRI examinations, this situation is poorly correlated with clinical improvement 28 . In addition, recent studies have revealed that chronic pain in AS patients is a mixed type of pain with both nociceptive and neuropathic components 9,10 . Wu et al 7 performed PD‐Q, mechanical and thermal thresholds and 3T brain MRI examinations in 17 patients with back pain secondary to AS and they identified significant brain abnormalities.…”

“…7 At the same time, the presence of symptoms such as burning sensation, hyperalgesia and allodynia that cannot be explained clearly with NoP and the presence of inconsistencies between inflammatory situation and severity of pain suggest that NP may be a component in patients with AS. 9,10 However, in clinical practice there are still some difficulties in detecting NP in these patients.…”

“…Only few studies have demonstrated the relationships between AS and the NP component using DN4 or painDETECT questionnaires (PD‐Q), and links of NP with high disease activity and low functional status in these patients 12,13 . Recently, in a meta‐analysis of 4 comparative studies, Kim et al 9 demonstrated that AS patients with NP had greater pain intensity, higher disease activity and poorer quality of life than non‐NP patients. Further, there are various studies revealing that chronic rheumatologic disorders (eg, rheumatoid arthritis, Sjögren's syndrome, osteoarthritis, and fibromyalgia syndrome) have NP components 14‐17 .…”

Spezielle Schmerztherapie bei rheumatischen Erkrankungen

“…B. mit Borrelien oder dem Herpes zoster als typische Nebenwirkung beim Einsatz von JAK-Inhibitoren, können neuropathische Schmerzen auftreten. Eine Mischung von nozizeptiver und neuropathischer Komponente (mixed pain Konzept) ist bei Osteoarthrose [108], rheumatoider Arthritis [109], Psoriasis Arthritis [110], Spondyloathritis [111], aber auch Kollagenosen wie systemischer Sklerose [112], SLE [113][114][115][116] und Sjögrens Syndrom [117] aufgrund verschiedener Mechanismen beschrieben. Die neuropathische Komponente muss für eine erfolgreiche Schmerztherapie bei der Behandlung von Patienten mit rheumatischen Erkrankungen beachtet werden, da herkömmliche Schmerzmedikation mit NSAR und auch die anti-entzündliche Therapie auf die neuropathische Komponente nur einen geringen Einfluss haben.…”