Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
Int J Rheum Dis. 2024 Apr;27(4):e15159. doi: 10.1111/1756-185X.15159.
Many rheumatoid arthritis (RA) patients prioritize pain improvement in treatment. As pain can result from various causes, including noninflammatory factors such as central sensitivity syndrome (CSS), we hypothesized that CSS might impact treatment satisfaction. In this cross-sectional study, we assessed the CSS effects on clinical disease activity and treatment satisfaction in RA patients.
In total, 220 consecutive RA patients receiving long-term follow-up were evaluated for clinical disease activity and treatment satisfaction. CSS was evaluated using the Central Sensitization Inventory (CSI). An overall score of ≥40 indicates the presence of CSS. We queried "How satisfied are you with your treatment?"; answers included (a) very satisfied, (b) satisfied, (c) not satisfied, or (d) very dissatisfied. For univariate analysis, we condensed these answers into "dissatisfied" or "satisfied." We also evaluated treatment satisfaction using the visual analog scale (VAS), with scores ranging from 0 mm (very dissatisfied) to 100 mm (very satisfied).
Of the 220 patients, 17 (7.7%) were classified as having CSS. CSI score was significantly correlated with the clinical disease activity index (CDAI; r = .322, p < .01) and treatment satisfaction (r = -.336, p < .01). Regarding treatment satisfaction, univariate analysis revealed that patient global assessment (PtGA), pain VAS, Health Assessment Questionnaire-Disability Index (HAQ-DI), Disease Activity Score in 28 joints with C-reactive protein, CDAI, and CSI scores of patients who were satisfied with treatment differed significantly from those of dissatisfied patients. Multivariate analysis revealed that CSI, PtGA, and HAQ-DI scores were associated with treatment satisfaction.
In RA patients, CSS may affect the disease activity index and reduce treatment satisfaction.
许多类风湿关节炎（RA）患者在治疗中优先考虑疼痛改善。由于疼痛可能由多种原因引起，包括中枢敏化综合征（CSS）等非炎症因素，我们假设 CSS 可能会影响治疗满意度。在这项横断面研究中，我们评估了 CSS 对 RA 患者临床疾病活动度和治疗满意度的影响。
共评估了 220 例接受长期随访的连续 RA 患者的临床疾病活动度和治疗满意度。使用中枢敏化量表（CSI）评估 CSS。总分≥40 表示存在 CSS。我们询问“您对治疗的满意度如何？”答案包括（a）非常满意、（b）满意、（c）不满意或（d）非常不满意。对于单变量分析，我们将这些答案归为“不满意”或“满意”。我们还使用视觉模拟量表（VAS）评估治疗满意度，得分范围为 0 毫米（非常不满意）至 100 毫米（非常满意）。
在 220 例患者中，17 例（7.7%）被归类为 CSS。CSI 评分与临床疾病活动指数（CDAI；r=0.322，p<0.01）和治疗满意度显著相关（r=-0.336，p<0.01）。关于治疗满意度，单变量分析显示，患者总体评估（PtGA）、疼痛 VAS、健康评估问卷-残疾指数（HAQ-DI）、28 个关节的 C 反应蛋白疾病活动评分、CDAI 和 CSI 评分满意的患者与不满意的患者有显著差异。多变量分析显示，CSI、PtGA 和 HAQ-DI 评分与治疗满意度相关。
在 RA 患者中，CSS 可能会影响疾病活动指数并降低治疗满意度。
