SAT0285 EVALUATION OF CHRONIC PAIN IN PATIENTS WITH SYSTEMIC SCLEROSIS COMPARED TO THOSE WITH CHRONIC HEADACHE AND RHEUMATOID ARTHRITIS
Authors: Luca Magnani, Federica Lumetti, Emanuele Cocchiara, Amelia Spinella, Carlo Baraldi, Luigialberto Pini, Lanfranco Pellesi, Gianluigi Baiocchi, Carlo Salvarani, Dilia Giuggioli
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Systemic Sclerosis (SSc) is a chronic systemic disease frequently leading to disability and low quality of life. Chronic pain (CP), due to severe disease complications and internal organs involvement, is often underestimated. Based on available data around a 60-70% of patient with SSc suffer of chronic pain but we still lacking of fine tools to better evaluate it and follow up patients <h3>Objectives:</h3> Evaluate pain in SSc patients, in terms of its intensity, sensory and affective components, the interference with physical and social activities, impact on quality of life and correlation with main SSc clinical manifestations. <h3>Methods:</h3> From January 2013 to January 2018 we retrospectively evaluated 98 patients with a diagnosis of SSc [F/M=87/11; Limited/Diffuse SSc 63/35 anti-Scl70/ACA/ANA nucleolar positivity 45/39/14; mean age 55,6 ± 12,6 DS; mean disease duration 9,9 ± 7,6 DS] according to 2013 ACR/EULAR criteria; 47 patients with a diagnosis of chronic headache (CH) as defined by the International Classification for Headache Disorders, Third Edition beta version (ICHD-3 beta) criteria [F/M 37/10; mean age 52,6 ± 14,2 DS; mean disease duration: 7 ±2 yrs DS] and 46 patients with Rheumatoid Arthritis [F/M 36/10, mean age 61±13, mean disease duration 10±2 yrs, DS]. All patients fulfilled self-complying questionnaires for the evaluation of pain and quality of life: Visual Analogic Scale (VAS), Numeric Rating Scale (NRS), Short Form-McGill Pain Questionnaire (SF-MPQ), Brief Pain Inventory Score (BPI) e Health Assessment Questionnaire (HAQ). <h3>Results:</h3> SSc patients started to suffer of CP in younger ages compared to AR/CH cohort but patients suffering of CH have higher mean scores in all questionnaires compared to AR/SSc. CH patients, have higher mean score in SFMPQ-sensory and affectory. Hundred percent (100%) of AR patients suffered of chronic pain. They, generally, had higher scores than SSc patients with a prevalence of the affectory component. The 83.9% (67/75 pts) of SSc patients experienced chronic pain [SF-MPQ PRI: 6.25±8.34DS; SF-MPQ PPI: 1.69±1.34DS; BPI-fattore1: 13.37±11.26DS; VAS: 40.7±29.6DS; NRS: 4.08±2.98DS] and in a great majority (84%) that pain interfered with their working activities and social lifes. Fortyeight percent of SSc patients had digital ulcers and 41.3% had musculoskeletal involvement. Pain used to correlate with both of them [p=0.004; p=0.041]. In patients with DUs, affectory component of pain overuled on the sensory one <h3>Conclusion:</h3> SSc patients frequently experience chronic pain and particularly those who have a history of active DUs and musculoskeletal involvement. By the way, it seems that the BPI questionnaire could be more suitable than VAS or NRS in assessing DUs' pain. Furthermore it provides useful information on the impact of CP on social life and work impairment. Otherwise, SF_MPQ allows clinicians to better discriminate affective or sensory components of pain. <h3>References</h3> [1] The impact of systemic sclerosis on health-related quality of life assessed by SF-36: A systematic review and meta-analysis. Li L, et al.; Int J Rheum Dis. 2018 Nov;21(11):1884-1893. <h3>Disclosure of Interests:</h3> Luca Magnani: None declared, Federica Lumetti: None declared, Emanuele Cocchiara: None declared, Amelia Spinella: None declared, CArlo Baraldi: None declared, Luigialberto Pini: None declared, Lanfranco Pellesi: None declared, Gianluigi Baiocchi: None declared, Carlo Salvarani Grant/research support from: Roche, Consultant for: Eli Lilly and Company, Roche, Abbvie, Dilia Giuggioli: None declared