Abstract
Background Objectives To study the efficacy of Pregabalin in the treatment of chronic pain in patients with rheumatoid arthritis. Methods We enrolled 80 patients with rheumatoid arthritis. Screening with the DN4 neuropathic pain questionnaire showed that 31% of patients (n=25) had a neuropathic pain component (NPC+), DN4>4 points. Mean age was 57,0 ±7,49 years, disease duration - 9.87 ± 9.5 years, DAS28 disease activity - 5.5 ± 1.3, VAS pain intensity - 73.1 ± 17.4. All patients were randomized into two groups: group I received pregabalin in combination with DMARDs; group II received DMARDs only. All patients underwent a clinical and neurological examination, disease activity was assessed with the DAS28 index, the effect of treatment on neuropathic pain was assessed with the DN4 and Pain DETECT questionnaires, pain intensity at rest – with the VAS scale. Results There were no significant differences between groups before the start of the study (Table 1) Positive dynamics of VAS pain intensity was observed in both groups [Fig. 1] (77.0 ± 13.5 vs 75.2 ± 14.7, at week 2 48.8 ± 14.2 vs 72.9 ± 16.9, at week 5 48.3 ± 34.2 vs 64.5 ± 20.2 p = 0.004). Neuropathic pain indices improved significantly according to the DN4 (5.2 ± 1.1 vs 5.0 ± 0.6, at week 5 2.3 ± 0.6 vs 4.5 ± 0.6) and Pain DETECT questionnaires (17.0 ± 3.2 vs 18.4 ± 2.2, at week 5 7.3 ± 3.06 vs 16.8 ± 3.8). However, disease activity did not differ significantly in either group (group I 5.6 ± 0.6 vs 4.8 ± 1.6 p = 0.4; group II 4.9 ± 0.3 vs 5.2 ± 1.2 p = 0.8). Conclusion This preliminary data shows greater effectiveness of Pregabalin in comparison with NSAID and DMARD treatment, both in terms of pain intensity and the neuropathic pain component, which is of practical importance. Disclosure of Interests: Ekaterina Filatova: None declared, Shandor Erdes Consultant for: Development of studies concepts., Speakers bureau: Educational meetings organized or supported by companies.
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