Pain catastrophizing negatively impacts drug retention rate in patients with Psoriatic Arthritis and axial Spondyloarthritis: results from a 2-years perspective multicenter GIRRCS (Gruppo Italiano di Ricerca in Reumatologia Clinica) study

IF 4.9 2区 医学 Q1 Medicine
Damiano Currado, Francesca Saracino, Piero Ruscitti, Annalisa Marino, Ilenia Pantano, Marta Vomero, Onorina Berardicurti, Viktoriya Pavlych, Claudio Di Vico, Francesco Caso, Luisa Costa, Marco Tasso, Federica Camarda, Francesca Misceo, Francesco De Vincenzo, Addolorata Corrado, Luisa Arcarese, Amelia Rigon, Marta Vadacca, Erika Corberi, Lyubomyra Kun, Francesca Trunfio, Andrea Pilato, Ludovica Lamberti, Francesco Paolo Cantatore, Federico Perosa, Giuliana Guggino, Raffaele Scarpa, Paola Cipriani, Francesco Ciccia, Roberto Giacomelli, Luca Navarini
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Abstract

Chronic pain and inflammation are common features of rheumatic conditions such as Psoriatic Arthritis (PsA) and Axial Spondyloarthritis (axSpA), often needing prolonged medication treatment for effective management. Maintaining drug retention is essential for both achieving disease control and improving patients' quality of life. This study investigates the influence of pain catastrophizing, a psychological response to pain, on the drug retention rates of PsA and axSpA patients. A two-year prospective multicenter observational study involved 135 PsA and 71 axSpA patients. Pain Catastrophizing Scale (PCS) was employed to assess pain catastrophizing. Univariable and multivariable regression analyses were utilized to identify factors associated with drug retention. In the PsA group, patients early discontinuing therapy showed higher baseline disease activity as well as higher incidence of comorbid fibromyalgia. Notably, pain catastrophizing, specifically the domains of Helplessness, Magnification, and Rumination, were significantly elevated in PsA patients who interrupted the treatment. Multivariable analysis confirmed pain catastrophizing as an independent predictor of drug suspension within two years. In axSpA, drug discontinuation was associated with female gender, shorter disease duration, higher baseline disease activity as well as elevated levels of pain catastrophizing. Univariable analysis supported the role of pain catastrophizing, including its domains, as predictors of treatment interruption. However, limited events in axSpA patients precluded a multivariate analysis. This prospective study emphasizes the impact of pain catastrophizing on drug retention in patients with PsA and axSpA.
疼痛灾难化对银屑病关节炎和轴性脊柱关节炎患者的药物保留率有负面影响:GIRRCS(Gruppo Italiano di Ricerca in Reumatologia Clinica)多中心 2 年透视研究的结果
慢性疼痛和炎症是银屑病关节炎(PsA)和轴性脊柱关节炎(axSpA)等风湿性疾病的常见特征,通常需要长期药物治疗才能有效控制。要实现疾病控制和改善患者的生活质量,就必须维持药物治疗。本研究调查了疼痛灾难化(一种对疼痛的心理反应)对 PsA 和 axSpA 患者药物保留率的影响。这项为期两年的前瞻性多中心观察研究涉及 135 名 PsA 和 71 名 axSpA 患者。采用疼痛灾难化量表(PCS)评估疼痛灾难化。采用单变量和多变量回归分析来确定与药物保留相关的因素。在 PsA 组中,早期停止治疗的患者基线疾病活动度较高,合并纤维肌痛的发生率也较高。值得注意的是,中断治疗的PsA患者的疼痛灾难化程度,特别是无助感、放大和反刍领域,明显升高。多变量分析证实,疼痛灾难化是两年内停药的独立预测因素。在 axSpA 中,停药与女性性别、较短的病程、较高的基线疾病活动度以及疼痛灾难化水平升高有关。单变量分析支持疼痛灾难化(包括其领域)是预测治疗中断的因素。然而,由于 axSpA 患者的活动有限,因此无法进行多变量分析。这项前瞻性研究强调了疼痛灾难化对 PsA 和 axSpA 患者留药的影响。
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来源期刊
CiteScore
8.60
自引率
2.00%
发文量
261
审稿时长
14 weeks
期刊介绍: Established in 1999, Arthritis Research and Therapy is an international, open access, peer-reviewed journal, publishing original articles in the area of musculoskeletal research and therapy as well as, reviews, commentaries and reports. A major focus of the journal is on the immunologic processes leading to inflammation, damage and repair as they relate to autoimmune rheumatic and musculoskeletal conditions, and which inform the translation of this knowledge into advances in clinical care. Original basic, translational and clinical research is considered for publication along with results of early and late phase therapeutic trials, especially as they pertain to the underpinning science that informs clinical observations in interventional studies.
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