Comparison of chronic widespread pain prevalence with different criteria in two cohorts of rheumatoid arthritis.
Clin Rheumatol
; 41(4): 1023-1032, 2022 Apr.
Article
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| MEDLINE
| ID: mdl-34812975
ABSTRACT
OBJECTIVE:
This study aims to investigate chronic widespread pain with the 1990 (CWP1990) and 2019 (CWP2019) definitions 6 years after the onset of rheumatoid arthritis (RA), in one patient cohort with tight controls and one conventional cohort, and factors associated with reporting CWP1990 and CWP2019, respectively.METHODS:
A cohort of 80 RA patients with monthly visits to the physician the first 6 months was compared to a cohort of 101 patients from the same clinic with conventional follow-up. Both cohorts had early RA (< 13 months). The prevalence of CWP1990 and the more stringent CWP2019 were in a 6-year follow-up investigated with a questionnaire, including a pain mannequin and a fear-avoidance beliefs questionnaire.RESULTS:
In the tight control cohort, 10% reported CWP2019 after 6 years compared to 23% in the conventional cohort (p = 0.026). There was no difference when using the CWP1990 definition (27% vs 31%, p = 0.546). When adjusted for important baseline data, the odds ratio for having CWP2019 was 2.57 (95% CI 1.02-6.50), in the conventional group compared to the tight control group (p = 0.046). A high level of fear-avoidance behaviour towards physical activity was associated with CWP2019, OR 10.66 (95% CI 1.01-112.14), but not with CWP1990 in the tight control cohort.CONCLUSION:
A more stringent definition of CWP identifies patients with a more serious pain condition, which potentially could be prevented by an initial tight control management. Besides tight control, caregivers should pay attention to fear-avoidance behaviour and tailor treatment. KEY POINTS ⢠CWP2019 is a more stringent definition of chronic widespread pain and identifies patients with a more serious pain condition. ⢠Patients with a serious pain condition could be helped by frequent follow-ups. ⢠This study suggests that a special attention of fear-avoidance behaviour towards physical activity in patients with RA is needed.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Artritis Reumatoide
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Dolor Crónico
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
Clin Rheumatol
Año:
2022
Tipo del documento:
Article