Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Motion Analysis Laboratory, Shriners Hospitals for Children, Chicago, Illinois, USA.
Am J Med Genet A. 2023 Jan;191(1):160-172. doi: 10.1002/ajmg.a.63009. Epub 2022 Oct 22.
The objective was to describe pain characteristics and treatments used in individuals with varying severity of osteogenesis imperfecta (OI) and investigate pain-associated variables. This work was derived from a multicenter, longitudinal, observational, natural history study of OI conducted at 12 clinical sites of the NIH Rare Diseases Clinical Research Network's Brittle Bone Disorders Consortium. Children and adults with a clinical, biochemical, or molecular diagnosis of OI were enrolled in the study. We did a cross-sectional analysis of chronic pain prevalence, characteristics, and treatments used for pain relief and longitudinal analysis to find the predictors of chronic pain. We included 861 individuals with OI, in 41.8% chronic pain was present, with similar frequency across OI types. Back pain was the most frequent location. Nonsteroidal anti-inflammatory drugs followed by bisphosphonates were the most common treatment used. Participants with chronic pain missed more days from school or work/year and performed worse in all mobility metrics than participants without chronic pain. The variables more significantly associated with chronic pain were age, sex, positive history of rodding surgery, scoliosis, other medical problems, assistive devices, lower standardized height, and higher body mass index. The predictors of chronic pain for all OI types were age, use of a wheelchair, and the number of fractures/year. Chronic pain is prevalent in OI across all OI types, affects mobility, and interferes with participation. Multiple covariates were associated with chronic pain.
目的是描述不同严重程度成骨不全症(OI)患者的疼痛特征和治疗方法,并探讨与疼痛相关的变量。这项工作源自 NIH 罕见疾病临床研究网络脆性骨疾病联盟的 12 个临床中心进行的一项多中心、纵向、观察性、自然史研究。患有临床、生化或分子诊断为 OI 的儿童和成人被纳入该研究。我们对慢性疼痛的患病率、特征以及用于缓解疼痛的治疗方法进行了横断面分析,并进行了纵向分析以寻找慢性疼痛的预测因素。我们纳入了 861 名 OI 患者,其中 41.8%存在慢性疼痛,各型 OI 的疼痛频率相似。背痛是最常见的疼痛部位。非甾体抗炎药和双膦酸盐是最常用的治疗药物。患有慢性疼痛的参与者比没有慢性疼痛的参与者每年从学校或工作中缺勤的天数更多,在所有移动性指标上的表现也更差。与慢性疼痛更显著相关的变量是年龄、性别、 rods 手术阳性史、脊柱侧凸、其他医疗问题、辅助设备、较低的标准化身高和较高的体重指数。所有 OI 类型慢性疼痛的预测因素是年龄、使用轮椅以及每年骨折的次数。慢性疼痛在所有 OI 类型中都很普遍,会影响移动性并干扰参与度。多个协变量与慢性疼痛相关。