Institute for Palliative Care, Region Skåne and Lund University, Lund, Sweden.
Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Scand J Rheumatol. 2021 Jul;50(4):271-279. doi: 10.1080/03009742.2020.1846778. Epub 2021 Feb 25.
: The aim of the study was to assess the development of widespread non-joint pain (WNP) in a cohort of patients with early rheumatoid arthritis (RA), the associated health-related quality of life (HRQoL), and clinical and demographic risk factors for WNP.: Incident cases with RA, from the Swedish population-based study Epidemiological Investigation of Rheumatoid Arthritis (EIRA), with a follow-up of at least 3 years, constituted the study population. WNP was defined as pain outside the joints in all four body quadrants and was assessed at the 3 year follow-up. Patients who reported WNP were compared to patients without WNP regarding HRQoL, measured by the Short Form-36, at 3 years, and clinical and demographic characteristics at the time of RA diagnosis.: A total of 749 patients constituted the study sample, of whom 25 were excluded after reporting already having severe pain before RA diagnosis. At the 3 year follow-up, 8% of the patients reported having WNP as well as statistically significant worse HRQoL. At the time of RA diagnosis, the patients with WNP had worse pain and pain-related features, while no difference was seen in the inflammatory parameters.: WNP occurs in a substantial subset of patients with RA, also early in the course of the disease, and the HRQoL for these patients is significantly reduced. Patients who develop WNP at 3 years are already distinguishable at the time of diagnosis by displaying more pronounced pain ratings together with an average level of inflammatory disease activity.
: 研究目的在于评估一组早期类风湿关节炎(RA)患者广泛非关节疼痛(WNP)的发展情况、与健康相关的生活质量(HRQoL)以及 WNP 的临床和人口统计学风险因素。: 本研究人群来自瑞典基于人群的类风湿关节炎流行病学研究(EIRA)中的新发 RA 病例,随访时间至少 3 年。WNP 的定义为四肢所有四个象限的关节外疼痛,并在 3 年随访时进行评估。报告 WNP 的患者与无 WNP 的患者在 3 年时的 HRQoL(通过 36 项简短健康调查量表进行评估)以及 RA 诊断时的临床和人口统计学特征进行比较。: 共有 749 名患者构成了研究样本,其中 25 名患者在报告 RA 诊断前已经有严重疼痛后被排除在外。在 3 年随访时,8%的患者报告有 WNP,且 HRQoL 明显更差。在 RA 诊断时,患有 WNP 的患者疼痛和疼痛相关特征更严重,而炎症参数无差异。: WNP 在相当一部分 RA 患者中发生,即使在疾病早期也是如此,这些患者的 HRQoL 明显降低。在 3 年时出现 WNP 的患者在诊断时已经可以通过显示更明显的疼痛评分以及炎症疾病活动的平均水平来区分。