Monforte Gasque María Pilar, Lázaro Gallardo Esteban Manuel, Lázaro Castellano Ana María, Querol Hernández Ana Cristina, Maroto García Estrella, Borrás Martí Ferrán
Servicio de Farmacia. Hospital Clínico Universitario Lozano Blesa. Zaragoza. España.
Servicio de Farmacia. Hospital Royo Villanova. Zaragoza. España..
An Sist Sanit Navar. 2022 Nov 22;45(3):e1020. doi: 10.23938/ASSN.1020.
To assess pain in patients with rheumatic disease under biological therapy treatment.
Observational retrospective study of patients with rheumatic disease under biological therapy treatment who visited the health care center as outpatients in February/August 2020. We collected demographic (sex and age), clinical (diagnosis, pain presence, intensity, and location), and pharmacological (biological therapy, concomitant treatment with traditional DMARDs, and analgesic treatment) variables from the electronic medical records and Farmatools Dominion®.
We included 138 patients; mean age was 56 years and 71% were female. The most frequent diagnosis (47%) was ankylosing spondylitis. Anti-TNF-a was the most prescribed biological drug (64%); 60.1% of study patients received traditional drugs, particularly methotrexate and leflunomide (51.8 and 28.9%, respectively). Pain was reported in 81% of the cases, particularly in hands (73.2%) and knees (69.6%); mean pain intensity was 6.5 (VAS). Although 83.3% of the patients had been prescribed analgesics, pain persisted in 84.8% of the cases (VAS >4), being severe or very severe in 67.9%. Over half of the patients (52.2%) used more than one analgesic. The most frequently prescribed medications were non-steroidal anti-inflammatory drugs (NSAIDs) (60%), paracetamol (52.2%), and opioids (56.5%). NSAIDs controlled pain (14.5%) better than opioids (8.3%); there was no post-treatment improvement of pain in 29.6% of the patients. The number of prescribed drugs increased with pain intensity (rho= 0.264; p= 0.006).
Almost 70% of study patients had uncontrolled severe rheumatic-related pain. This implies a challenge for establishing effective treatments for this type of pain.
评估接受生物疗法治疗的风湿性疾病患者的疼痛情况。
对2020年2月/8月在医疗保健中心门诊接受生物疗法治疗的风湿性疾病患者进行观察性回顾研究。我们从电子病历和Farmatools Dominion®中收集了人口统计学（性别和年龄）、临床（诊断、疼痛存在情况、强度和部位）以及药理学（生物疗法、与传统改善病情抗风湿药的联合治疗和镇痛治疗）变量。
我们纳入了138例患者；平均年龄为56岁，71%为女性。最常见的诊断（47%）是强直性脊柱炎。抗TNF-α是最常处方的生物药物（64%）；60.1%的研究患者接受了传统药物治疗，尤其是甲氨蝶呤和来氟米特（分别为51.8%和28.9%）。81%的病例报告有疼痛，尤其是手部（73.2%）和膝盖（69.6%）；平均疼痛强度为6.五分制疼痛评分法）。尽管83.3%的患者已被处方使用镇痛药，但84.8%的病例疼痛仍持续存在（五分制疼痛评分法>4），其中67.9%为重度或极重度疼痛。超过一半的患者（52.2%）使用了不止一种镇痛药。最常处方的药物是非甾体抗炎药（60%）、对乙酰氨基酚（52.2%）和阿片类药物（56.5%）。非甾体抗炎药控制疼痛的效果（14.5%）优于阿片类药物（8.3%）；29.6%的患者疼痛在治疗后没有改善。处方药物的数量随疼痛强度增加（斯皮尔曼相关系数=0.264；p=0.006）。
近70%的研究患者有未得到控制的严重风湿相关疼痛。这意味着为这类疼痛建立有效治疗方法面临挑战。
