Pain over 5 years in our EARLY Rheumatoid Arthritis UCLouvain Brussels cohort: results and correlation with clinical response, quality of life and other parameters

Details

Supervisors

Cayrol, Timothée ; Durez, Patrick

Faculty

Faculté des sciences de la motricité

Degree label

Master [60] en kinésithérapie et réadaptation

Abstract

Background: Rheumatoid arthritis is a chronic inflammatory disease that affects 0.5 to 1% of the world's population. One of the most common symptoms among patients is pain. It affects patients' daily lives by diminishing their quality of life. Objective: Firstly, to observe the evolution of pain and to detect the proportion of patients suffering from unacceptable pain at the end of the 5-year study. Secondly, to witness the correlation of pain with the DAS28-CRP and HAQ scores. Method: All 474 patients were treated according to the standard of care, mainly with Methotrexate. All measurements were taken at baseline, 6, 12, 36, 60 months. VASp, HAQ, and DAS28-CRP were the endpoints of this study. Unacceptable pain was considered superior 40mm on a 100mm scale. SDAI, CDAI, VASd, VASf were also assessed at all timelines with the other parameters. Results: At baseline, smokers (p = 0.0373) and patients with a family history rheumatoid arthritis (p = 0.0067) had higher chances to have unacceptable pain. Body mass index, sex, anti-citrullinated protein antibody, rheumatoid factors, diabetes, high blood pressure or hypercholesterolemia were not associated with unacceptable pain. After the 5-year follow-up, only 33.7% of all patients still had unacceptable pain, against 78% at the beginning of the study. Unacceptable pain during the 5-year follow-up was associated with higher VASp, DAS28-CRP, HAQ, VASf, SDAI and CDAI at baseline with a p < 0.001. At every timeline, higher VASp was associated with higher DAS28-CRP (p < 0.001), higher HAQ (p < 0.001), higher VASd (p < 0.001) and higher VASf (p < 0.001). Conclusion: A significant decrease in pain was observed over the first 6 months with rheumatoid arthritis patients. 33.7 % of the population remains with unacceptable pain at the end of 5 years, and it is associated with higher VASp, DAS28-CRP, HAQ, and VASf values.