Predictors of Pain for Patients With Early Inflammatory Polyarthritis

Abstract

Objective. To identify predictors of pain at 1 year in patients with early inflammatory polyarthritis (EIP).Methods. Using a prospective design, patients were examined by a rheumatologist and completed questionnaires at baseline and at 1 year after symptom onset. Separate regression analyses were run for pain intensity, sensory pain, and affective pain. Age and sex were adjusted in cross-sectional and longitudinal analyses; baseline potential predictors consisted of measures for corresponding pain values and disease activity, depression, coping scores, medication use, rheumatoid arthritis criteria being met, and duration of symptoms. Results. A total of 211 patients were enrolled in the study (mean ؎ SD age 58.8 ؎ 14.2 years, 63% women). There were significant improvements at 1 year for disease activity, instrumental coping, emotional coping, depression, and all 3 pain measures. At baseline, disease activity and depression were positively associated with all types of pain; in addition, instrumental coping was positively associated with sensory pain and palliative coping was positively associated with affective pain. At 1 year, pain intensity was predicted by baseline pain intensity, duration of symptoms, use of disease-modifying antirheumatic drugs (DMARDs), and emotional coping. Sensory pain was predicted by baseline sensory pain and DMARD use. Affective pain was predicted by baseline affective pain, DMARD use, and emotional coping. Conclusion. The majority of treated EIP patients can expect improvements in clinical and psychosocial variables over the first year of their illness. Emotional coping at baseline may contribute to pain in the future, and therefore it may be useful for patients to learn other means of dealing with this chronic disease.

Secular changes in functional disability, pain, fatigue and mental well-being in early rheumatoid arthritis. A longitudinal meta-analysis

“…Following title and abstract screening, 1,736 full texts were screened for eligibility. In total, 41 articles 11,22,[32][33][34][35][36][37][38][39][40][41]24,[42][43][44][45][46][47][48][49][50][51]25,[52][53][54][55][56][57][58][59][60][61]26,62,[27][28][29][30][31] describing data from 46 cohorts where identified, contributing a combined total of 18,046 patients. The median year of recruitment for all cohorts ranged from 1983-2014, with a median year of 2002.…”

Serum levels of 14-3-3η protein supplement C-reactive protein and rheumatoid arthritis-associated antibodies to predict clinical and radiographic outcomes in a prospective cohort of patients with recent-onset inflammatory polyarthritis

“…Median symptom duration at baseline was 3 months, and over 92 % already fulfilled either the 1987 ACR or the 2010 ACR/EULAR classification criteria for RA. We previously reported that not meeting the 1987 ACR criteria for RA at baseline did not significantly impact subsequent outcomes in our patients [ 10 , 16 ]. Disease activity was moderate to high: median (IQR) SDAI 30.1 (19.8–45.2); median M-HAQ (IQR) 0.8 (0.4-1.4).…”

“…Baseline joint damage was low, with median total SvH (IQR) of 2 (0–6) and median erosion SvH (IQR) of 1 (0–3). Patients rapidly received DMARDs, usually methotrexate (MTX), alone or in combination with other DMARDs [ 8 – 10 , 16 ].…”

“…The longitudinal EUPA cohort was previously described [ 8 – 10 ]. Starting in 1998, consecutive adult patients with at least three swollen joints for one to twelve months were evaluated at the Centre hospitalier universitaire de Sherbrooke (CHUS) and asked to participate.…”

Pain in primary Sjögren’s syndrome: the role of catastrophizing and negative illness perceptions

“…Over the past decade, the psychological construct of pain catastrophizing has been studied in numerous rheu-matic disorders (5)(6)(7). Catastrophizing is correlated with the intensity of chronic pain as well as with the severity of acute pain in a post-surgical setting (8).…”