Unacceptable pain in the BARFOT inception cohort of patients with rheumatoid arthritis : a long-term study

Objectives: Pain is the most common and troublesome complaint in rheumatoid arthritis (RA). This study aimed to assess the prevalence and clinical implications of unacceptable pain in an inception cohort of patients with RA. Method: This study followed 477 patients from the BARFOT (Better Anti-Rheumatic FarmacOTherapy) early RA cohort for 15 years. Unacceptable pain was defined as ≥ 40 mm on a visual analogue scale for pain, while tolerable pain denoted no pain or pain below this cut-off, according to the patient acceptable symptom state concept. Results: Unacceptable pain was frequent. At the 15 year follow-up visit, 34% had unacceptable pain. Patients with unacceptable pain had, compared with patients with tolerable pain, significantly more disease activity, worse patient global assessment, and worse function on the Health Assessment Questionnaire and Signals of Functional Impairment, but the degree of joint destruction was similar. Disease-modifying anti-rheumatic drug treatment was similar, but patients with unacceptable pain were more often treated with corticosteroids. At 15 years, patients with unacceptable pain who were in remission (33%) had less inflammation and better function than those not in remission, suggesting the presence of non-inflammatory causes of pain. Conclusions: In this cohort of patients with RA, pain was frequent and severe, with negative effects on experienced health and function. Unacceptable pain was frequent and occurred also in patients in remission, indicating that pain in RA is multifactorial and should always be regarded as an important concern in itself. The cause of pain should be recognized and treated appropriately.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:49

Enthalten in:

Scandinavian journal of rheumatology - 49(2020), 5 vom: 04. Sept., Seite 371-378

Sprache:

Englisch

Beteiligte Personen:

Svensson, B [VerfasserIn]
Forslind, K [VerfasserIn]
Andersson, M [VerfasserIn]

Links:

Volltext

Themen:

Antirheumatic Agents
Journal Article

Anmerkungen:

Date Completed 26.01.2021

Date Revised 26.01.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1080/03009742.2020.1729404

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM310764300