FRI0211 Association of neuropathic-like pain characteristics with clinical and radiographic features in patients with ankylosing spondylitis
Authors: S.-H. Lee, H.-R. Kim, K.-A. Lee
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Ankylosing spondylitis (AS) is a chronic progressive inflammatory disorder that mainly involves the axial skeleton and causes chronic back pain. It is not unusual for patients with AS to have symptoms similar to neuropathic pain. There were several studies showing that various rheumatic diseases, including rheumatoid arthritis, primary Sjogren syndrome, and fibromyalgia, had neuropathic pain components. However, the existence of neuropathic pain in patients with AS has not been well investigated. The painDETECT questionnaire (PD-Q) is a relatively simple and self-administered screening tool for determining neuropathic pain and has high sensitivity, specificity, and positive predictive accuracy values. <h3>Objectives</h3> The aim of this study was to investigate the neuropathic pain component in patients with AS using PD-Q, and to assess the relation between neuropathic pain and disease characteristics of AS. <h3>Methods</h3> A single-centre prospective study was performed on 105 patients. The patients with AS completed three questionnaires: PD-Q, Beck depression inventory (BDI), and Euro Quality of life (EQ-5D) questionnaires. Patients were classified into three groups according to the PD-Q scores: nociceptive pain (NoP) (score &lt;13), mixed pain (MP) (score 13–18), and neuropathic (NeP) (score &gt;18) pain. Fifteen patients (14.3%) were classified in the NeP group, 22 patients (21.0%) in the MP group, and 68 patients (64.7%) in the NoP group. The questionnaires and clinical and radiographic findings were analysed. <h3>Results</h3> Patients with NeP and MP scored worse on Bath ankylosing spondylitis disease activity index (BASDAI), BDI, modified Stoke Ankylosing Spondylitis Spine Score, pain-visual analogue scale (VAS), EQ-5L index, and showed an increased prevalence of enthesitis and peripheral arthritis (table 1). There were no differences in objective inflammatory markers. PD-Q scores positively correlated with pain-VAS, BASDAI, BDI, and inversely correlated with EQ-5D index (figure 1). Presence of enthesitis, BDI, age, and pain VAS score independently associated with PD-Q scores. <h3>Conclusions</h3> The findings showed a neuropathic pain component in AS. Neuropathic pain in AS was associated with age, high disease activity, radiographic progression, enthesitis, peripheral arthritis, depression, and low quality of life. <h3>References</h3> [1] Sung JK, Choi JH, Jeong J, et al. Korean Version of the pain DETECT Questionnaire: A Study for Cultural Adaptation and Validation. Pain Pract2017;17:494–504. [2] Validity and responsiveness of EuroQol-5 dimension (EQ-5D) versus Short Form-6 dimension (SF-6D) questionnaire in chronic pain. Health Qual Life Outcomes2013;11:110. [3] Campochiaro C, Caruso PF. Ankylosing Spondylitis and Axial Spondyloarthritis. N Engl J Med2016;375:1302. [4] Neuropathic pain in ankylosing spondylitis: A psychophysics and brain imaging study. Arthritis Rheum2013;65:1494–503. <h3>Acknowledgements</h3> The authors received no financial support for the research, authorship, and/or publication of this article. <h3>Disclosure of Interest</h3> None declared