AB0149 ASSESSMENT OF THE CENTRAL SENSITIZATION BY THE CENTRAL SENSITIZATION INVENTORY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Background:

Pain is one of the most prominent symptoms of rheumatoid arthritis (RA), which significantly affects the functional capabilities of such patients and significantly worsens their quality of life [1]. Recent evidence has demonstrated that Central Sensitization (CS) may be a new mechanism for the pain experienced by these patients [2]. The Central Sensitization Inventory (CSI) is a new self-report screening instrument to identify patients whose symptoms may be related to the phenomenon of CS [3].

Objectives:

Our aim was to determine the prevalence of central sensitization in RA patients using CSI.

Methods:

The study involved patients with RA according to ACR/EULAR (2010) criteria. We administered to all the subjects in the study the CSI, a questionnaire that has been used for the diagnosis of central sensitivity syndromes (CSS). DAS28-ESR, CDAI, SDAI, pain VAS, and HAQ-DI were compared in the "CS group (CSI ≧ 40)" and the "non-CS group (CSI < 40)". Statistical analysis was performed in MS Excel and SPSS 22 (©SPSS Inc.). Odds Ratio (OR) and 95% Confidence Intervals (CI) were calculated. Means and standard deviations (SD) were used to describe our population.

Results:

Overall, 176 patients with RA (median age, 52.2 ± 1.5 years; 78% female) and 36 controls (median age, 44,5 ± 2 years; 72% female) were included, of which 36% and 11%, respectively, had a CS (CSI score of 40 or higher), p < 0.001. RA patients had an odds ratio of 5.8 [95% CI: 1.9 – 17.1] (p < 0.05) for development of CS compared with controls. Moreover, severity levels of central sensitization among the RA patients ranged from subclinical to extreme: subclinical (CSI = 0 - 29) – 38%, mild (CSI = 30 - 39) – 26%, moderate (CSI = 40 - 49) – 16%, severe (CSI = 50 - 59) – 14% and extreme (CSI = 60 - 100) – 6%. It was found that the group of patients with CS had higher rates of disease-specific values compared to patients without CS: DAS28-ESR – 5.4 ± 0.8 vs. 4.6 ± 0.8; CDAI – 37.6 ± 8.9 vs. 28.2 ± 7.4; SDAI – 41 ± 8,6 vs. 30.8 ± 7.9; pain VAS - 7.8 ± 1.1 vs. 6.2 ± 1.4; HAQ – 1.9 ± 0.6 vs. 0.9 ± 0.5. Significance of differences between groups was at the level of p < 0.001.

Conclusion:

Central sensitization is common in RA patients. In the present study, admission CSI scores were highly associated with disease-specific values in RA patients. The CSI may have important clinical utility as a screening and treatment outcome measure for patients with RA.

REFERENCES:

[1] Martinec, R., Pinjatela, R., & Balen, D. (2019). QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS - A PRELIMINARY STUDY. Acta clinica Croatica, 58(1), 157–166. https://doi.org/10.20471/acc.2019.58.01.20 [2] Nijs, Jo, George, Steven Z, Clauw, Daniel J, Fernández-de-las-Peñas, César, Kosek, Eva, Ickmans, Kelly, Fernández-Carnero, Josué, Polli, Andrea, Kapreli, Eleni, Huysmans, Eva, Cuesta-Vargas, Antonio I, Mani, Ramakrishnan, Lundberg, Mari, Leysen, Laurence, Rice, David, Sterling, Michele, and Curatolo, Michele (2021). Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. The Lancet Rheumatology 3 (5) e383-e392. https://doi.org/10.1016/S2665-9913(21)00032-1. [3] Neblett, R. (2018). The central sensitization inventory: A user's manual. Journal of Applied Biobehavioral Research, 23(2), e12123. doi:10.1111/jabr.12123.

Acknowledgements:

NIL.

Disclosure of Interests:

None declared.