Neuropathic pain in rheumatoid arthritis

Филатова, Е. С.; Лила, А. М.; Parfenov, V. А.

doi:10.14412/2074-2711-2020-5-60-65

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…As expected, it was also observed association of neuropathic pain with peripheral neuropathy ( P = 0.016) and neuropathy was found in 72.2% of patients with neuropathic pain as well as in the study of Filatova and Erdes [ 33 ] who found it in 96%.…”

Section: Discussionsupporting

confidence: 81%

“…Age in this study, showed a surprisingly negative correlation with the number of falls in the previous 12 months (r = − 0.375, P = 0.032) different from that found in the general population in which age is an important risk factor [ 7 , 34 ]. Studies in RA found no relationship between age and falls [ 4 , 33 , 35 ]. We found a small negative association between age and falls, but the lower mobility of the older patients could be associated to a lower occurrence of falls.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of peripheral neuropathy in lower limbs of patients with rheumatoid arthritis and its relation to fall risk

2022

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Background Rheumatoid Arthritis (RA) is a chronic disabling systemic disease characterized by joint inflammation, and extra-articular manifestations, including peripheral neuropathy, a condition that can be associated with changes in muscle strength, proprioception and postural balance contributing for the risk of falls. The objective of this study is to analyze the incidence of peripheral neuropathy in patients with RA and its association with the occurrence of falls. Methods Patients were assessed by an electroneuromyography (ENMG) exam and by a questionnaire on accidental falls occurrence in the previous 12 months. They were also assessed on balance by the Short Physical Performance Battery (SPPB), functionality by the Health Assessment Questionnaire (HAQ), disease activity by the Disease Activity Score (DAS-28), neuropathic pain by the Questionnaire for the Diagnosis of Neuropathic Pain (DN4), and cutaneous sensitivity of the feet by the monofilament testing of Semmes–Weinstein. Monthly calls on falls were made in the subsequent six months. Data analysis was performed using the Shapiro–Wilk test for normality and Spearman, Chi-square, and T-student correlation tests, with a significant P level ≤ 0.05. Results A sample of 33 patients were evaluated. The incidence of peripheral neuropathy was 48.5%, of which 68.7% were axonal and 31.3% myelinic. The sensorimotor type was present in 64.7%, motor in 17.6%, and sensorial in 11.7% of the cases. Neuropathy was associated to balance (P = 0.026), neuropathic pain (P = 0.016), deep tendon reflexes absence (P = 0,049), altered skin sensitivity of the feet (P = 0.029) and fear of falling (P = 0.001). No association was found between peripheral neuropathy and age, gender, disease activity, or functionality. No significant association was found between peripheral neuropathy and occurrence of falls, in a 12-month retrospective and 6-month prospective evaluation. Conclusion Peripheral neuropathy has a high incidence in patients with RA, and is related to neuropathic pain, altered postural balance, but not to the occurrence of falls.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Evaluation of peripheral neuropathy in lower limbs of patients with rheumatoid arthritis and its relation to fall risk

2022

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Fibromyalgia in rheumatoid arthritis: features of pain syndrome, impact on disease activity and quality of life of patients

Melikova¹,

Филатова

Лила³

2022

Sovremennaâ revmatologiâ

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The prevalence of fibromyalgia (FM) in the general population is 2–8%, and among patients with rheumatic diseases it is 2–3 times higher. The presence of comorbid FM significantly affects the course of rheumatoid arthritis (RA).Objective: to assess the effect of FM on RA activity indicators, features of pain syndrome, and quality of life (QoL) of patients.Patients and methods. The study included patients with a confirmed diagnosis of RA. RA activity was assessed by the DAS28 index. FM was diagnosed according to the 2016 ACR criteria using the FM Diagnostic Questionnaire (FSQ). Patients also completed the central sensitization questionnaires – CS (CSI) and PainDETECT (PD). Pain intensity at rest was assessed using a visual analog scale (VAS, 10 cm), QoL was assessed using the FIQR and EQ-5D questionnaires.Results and discussion. 55 patients with RA were examined. FM was diagnosed in 24 of them (43.6%). RA activity in the presence and absence of FM (FM+ and FM- respectively) was high: the DAS28 index in the FM+ group averaged 4.58 points, and in the FM- group it was 5.14 points (p=0.227). The median pain intensity according to VAS in the FM+ and FM- groups was 6.5 and 4.0 cm, respectively (p=0.017). Symptoms of CS were more common in patients with FM than in patients without FM (p=0.004). The median score on the PD questionnaire in the FM+ and FM- groups reached 17.5 and 11.0 points, respectively (p=0.015). Patients with FM had lower QoL scores both in EQ-5D (p=0.037) and FIQR (p<0.001).Conclusion. FM is a serious burden for RA patients. The pain syndrome in the presence of FM is of greater intensity and prevalence, accompanied by neuropathic descriptors, which significantly worsens the quality of life in patients with RA.

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Quality of life of patients with rheumatoid arthritis and comorbid fibromyalgia

Melikova

Филатова²,

Филатова

et al. 2023

RJTAO

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Objective: to evaluate the impact of comorbid fibromyalgia (FM) on the quality of life (QoL) of patients with rheumatoid arthritis (RA). Material and methods. The study involved 90 patients with confirmed RA who complained of chronic pain. All patients underwent general clinical and laboratory examination. FM was diagnosed according to the 2016 ACR criteria. The questionnaires assessed the presence and severity of fatigue (FSS), anxiety and depression (HADS), sleep disorders (PSQI), cognitive impairment (DSST), symptoms of central sensitization (CSI) and the neuropathic component of pain (DN4, PD). The severity of pain syndrome (PS) was assessed by 10-cm VAS at rest. QoL was assessed using the EQ-5D questionnaire. Results. In the main (FM+) and control (FM-) groups, the average severity of PS according to VAS at rest was 7 and 4 cm (p<0.001), the average score on the CSI questionnaire was 50 and 38.5 (p<0.001), and according to the PD questionnaire – 17 and 11 (p<0.001), respectively. Analysis of the severity of comorbid disorders revealed significant differences between the groups in terms of such parameters as fatigue (p=0.003), anxiety (p=0.001), sleep quality (p<0.001) and cognitive impairment (p=0.021). The QoL of patients (according to EQ-5D) in the main group was significantly lower (0.52 vs. 0.59; p=0.003). Significant correlations were found between the QoL index according to EQ-5D and VAS, FSS and PD values in both groups, CSI, DN4, HADS-T parameters and the number of painful joints – only in the main group. Conclusion. Concomitant FM significantly reduces the QoL of patients with RA. The main factors affecting QoL in patients with RA and comorbid FM were the intensity and neuropathic phenotype of PS, increased fatigue and anxiety. Patients with FM are also significantly more likely to have sleep and cognitive impairments.

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Neuropathic pain in rheumatoid arthritis

Cited by 3 publications

References 28 publications

Evaluation of peripheral neuropathy in lower limbs of patients with rheumatoid arthritis and its relation to fall risk

Evaluation of peripheral neuropathy in lower limbs of patients with rheumatoid arthritis and its relation to fall risk

Fibromyalgia in rheumatoid arthritis: features of pain syndrome, impact on disease activity and quality of life of patients

Quality of life of patients with rheumatoid arthritis and comorbid fibromyalgia

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