AB0292 A CROSS-SECTIONAL STUDY OF THE CENTRAL SENSITIVITY SYNDROME USING THE CENTRAL SENSITIZATION INVENTORY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

BackgroundDespite having low levels of inflammation, 47.3% of patients with rheumatoid arthritis (RA) continued to report moderate-to-high pain and fatigue [1], indicating that chronic pain can interfere with disease activity assessment. And chronic pain have linked to central sensitization syndromes (CSSs) of pain [2]. The central sensitization inventory (CSI) is a valid and reliable tool for detecting CSS, its severity, and associated syndromes [3]. However, there have been few reports of CSS in patients with RA being analysed with CSI.ObjectivesThis study aims to conduct a cross-sectional analysis of CSS in RA patients using the CSI and investigate the relationship with disease activity.MethodsWe performed a retrospective, cross-sectional study on 269 consecutive RA patients (70 males and 196 females; mean ± SD = 69.9 ± 12.2 years, range: 27–92 years; mean ± SD, disease duration: 12.9 ± 10.4 years, range: 0–55 years; mean ± SD DAS28CRP: 1.89 ± 0.78; range: 0.99–4.88). Patients were evaluated by the CSI; clinical and laboratory examinations were performed on all patients on the same day. SJC, TJC, CRP, ESR, PtVAS, pain VAS, DAS28CRP, DAS28ESR, HAQ-DI, and CDAI were compared in the “CSS group (CSI ≧ 40)” and the “non-CSS group (CSI < 40)” [4]. Furthermore, the relationship between each parameter and the CSI was also investigated.ResultsCSI had a mean ± SD of 18.4 ± 14.6. CSI ≥ 40 was found in 9.6% (26 patients). The number of PtGA, pain VAS, CDAI, and HAQ-DI were all significantly higher in the “CSS group” than in the “non-CSS group” (Table 1). PtGA (r = 0.352, p < 0.001), pain VAS (r = 0.369, p < 0.001), CDAI (r = 0.253, p < 0.001), and HAQ-DI (r = 0.477, p < 0.001) were all found to have significant correlations with CSI.Table 1.Compared with CSS group and non-CSS groupCSS group(n=26)Mean±SD, %non-CSS group (n=243) Mean±SD, %p valueDisease duration (years)15.4±11.312.6±10.30.202Steinbrocker stage 1 2/3 4(%)26.9/73.145.9/54.10.064Tender joint count (0-28)0.7±0.90.4±0.90.054Swollen joint count (0-28)0.2±0.50.4±1.00.389CRP (mg/dl)0.38±0.670.47±1.020.874ESR (mm)15.4±16.918.0±18.30.636PtGA (VAS/100mm)37.3±24.220.2±23.7<0.001*DAS28CRP2.14±0.801.85±0.770.068CDAI5.23±28.43.46±3.82<0.01*Pain VAS/100mm42.1±28.419.4±23.2<0.001*HAQ-DI1.41±0.970.40±0.64<0.001**significantConclusionIn RA patients, CSI was not associated with inflammation (CRP or ESR) but was related to subjective assessment (PtGA or pain VAS), functional impairment, and disease activity (CDAI). CSS may influence disease activity assessment, and CSS treatment may improve functional impairment.