Влияние ноципластической боли на клинические проявления и качество жизни у пациентов с аксиальным псориатическим артритом

Abstract

The purpose — to determine clinical and laboratory features of axial psoriatic arthritis (AxPsA); to study the impact of nociplastic pain (NP) on the clinical features and quality of life (QoL) in patients with AxPsA. Material and methods. 127 adult patients with psoriatic arthritis (PsA) were included. The number of tender (TJ) and swollen joints (SJ), patient global assessment and severity of pain, C-reactive protein (CRP) were determined. Activity of PsA was assessed with DAPSA, ASDAS, and BASDAI. NP was determined by screening using the CSI and neurologist’s examination. Sacroiliitis (SI) was determined with MRI. QoL was assessed with PsAID-12 and ASAS-HI. Results. SI was found in 60 (47.2%) patients with PsA (AxPsA). The TJ, SJ, CRP, DAPSA, ASDAS were found in higher values and values of CRP above normal, erosive peripheral arthritis and enthesitis were more often found in patients with AxPsA. NP was found in 30 (50%) patients with AxPsA who showed worse pain scores, BASDAI, ASDAS, and QoL. The indicators of TJ, SJ, and CRP in the groups did not differ. Conclusion. SI in PsA is associated with more severe peripheral and laboratory manifestations, but not with more severe pain. Patients with AxPsA with NP have higher rates of disease activity which are associated with degradation of patient reported outcomes including QoL without degradation of inflammation signs. For improving the QoL of patients with PsA it is necessary to study the mechanisms of chronic pain.