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Discrete Trajectories of Persistent Pain Identified in Rheumatoid Arthritis

In patients with rheumatoid arthritis treated with anti-inflammatory medications, long-term persistent pain was found to be common and may be predicted by higher levels of disability and a history of smoking.

In patients with rheumatoid arthritis (RA) treated with anti-inflammatory medications, long-term persistent pain was found to be common and may be predicted by higher levels of disability and a history of smoking, according to a study published in the Journal of Pain.

The investigators obtained 3-year short-form (SF)-36-Bodily Pain scores from patients with RA receiving treatment in the Early RA Network (n=683), the British Society for Rheumatology Biologics Register Biologics (n=7090), and the non-biologics (n=1720) cohorts. Baseline variables were examined for identified pain trajectories (using SF-36-Bodily Pain scores), and their predictive power for pain trajectories was analyzed using logistic regression. A subgroup analysis of individuals with normal inflammatory markers after 3 years was performed to examine the role of inflammation in this cohort.

Although mean SF-36-Bodily Pain scores were found to improve in each cohort (<.001 for all), all had scores >1 standard deviation worse than the UK general population. Discrete “persistent pain” (59%-79%) and “resolving pain” (19%-27%) distinct trajectories were identified for each cohort, and the Early RA Network cohort had an additional trajectory with “persistently low pain” (23%). Approximately 65% of patients with normal inflammatory marker levels after 3 years had a “persistent pain” trajectory. Risk factors for “persistent pain” trajectories in each cohort included greater disability (adjusted odds ratio], 2.3-2.5 per unit baseline Health Assessment Questionnaire score) and smoking history (adjusted odds ratio, 1.6-1.8).

Read on: Discrete Trajectories of Persistent Pain Identified in Rheumatoid Arthritis

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