THU0372 NEUROPATHIC PAIN IN THE PATIENTS WITH SPONDYLOARTHRITIS: RELATINSHIP WITH FATIGUE, SLEEP QUALITY AND QUALITY OF LIFE
Authors: Meral Bayram, Gamze Alayli, Ayhan Bilgici, Dilek Durmus, Omer Kuru
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Neuropathic pain is defined as the pain that arises as a direct consequence of a lesion or diseases affecting the somatosensory system. Low back pain has nociceptive, neuropathic or mixed components. Inflammatory back pain is one of the key clinical criteria for the classification of spondyloarthritis (SpA). There are no accurate data for the overall prevalence of neuropathic pain in the inflammatory disorders. <h3>Objectives</h3> In the present study we aimed to determine whether there is a neuropathic component in SpA and also to determine the relationship with disease activity, clinical findings, fatigue, sleep quality and quality of life. <h3>Methods</h3> Eighty SpA patients fulfilling the Assessment of SpondyloArthritis International Society (ASAS) classification criteria for SpA (M/F=42/38) (37.3±11 years), 53 patients with chronic low back pain (CLBP) (M/F=22/31) (45.5±13.6 years) and 50 healthy controls (M/F =28/22) (38.1 ±12.7years) were enrolled in the study. Pain was assessed with visual analogue scale (VAS rest and activity), disease activity with Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functional capacity with Bath Ankylosing Spondylitis Functional Index (BASFI), fatigue with multidimensional assessment of fatigue (MAF), sleep quality with Pittsburgh Sleep Quality Index (PSQI) and quality of life was assessed with Short Form 36 (SF-36). Neuropathic pain was determined by using painDETECT questionnaire, a simple and reliable screening questionnaire. Scores ≤12 indicate that a neuropathic pain component is unlikely, and scores ≥19 indicate that neuropathic component is very likely to be present. Scores between 12 and 19 suggest that the result is unclear. <h3>Results</h3> The PainDETECT score of the SpA patients, CLBP patients and healthy controls were 12.06±5.9, 13.8±7.5, 2.6±4.2, respectively. While there was no significant difference between the patients with SpA and CLBP (p&gt;0.05), the SpA patients had significantly higher scores than the healthy controls (p&lt;0.0001). 14 (17.5%) of the SpA patients, 14 (26.4%) of the CLBP patients and none of the healthy controls had PainDETECT score ≥19 (p&lt;0.05). The MAF score and all subscales of SF 36 all components were significantly different in the three groups (p&lt;0.05). There were also statistically significant differences between three groups for all subscales of PSQI except duration of sleep and need medications to sleep (p&lt;0.05). PainDETECT score was positively correlated with VAS rest, BASDAI, and BASFI in the patients with SpA. While PainDETECT score was positively correlated with MAF and total PSQI, sleep quality, sleep disturbance, daytime dysfunction scores, it was negatively correlated with SF-36 subscales of social functioning, mental health, general health, bodily pain (p&lt;0.05). <h3>Conclusion</h3> We found that SpA and CLBP patients had higher painDETECT scores than the healthy controls. 17% of the SpA patients had neuropathic pain. We also found that neuropathic pain was correlated with fatigue, sleep quality and quality of life. Since pain in SpA consists of inflammatory and neuropathic components, a better understanding of neuropathic pain mechanisms in SpA will provide a more targeted approach to the assessment and treatment of patients. <h3>References</h3> [1] Bidad K, Gracey E, Hemington KS, et al. Pain in ankylosing spondylitis: a neuro-immune collaboration. Nat Rev Rheumatol. 2017;13(7):410-420 [2] Bennett MI, Attal N, Backonja MM, et al. Using screening tools to identify neuropathic pain. Pain2007;127(3):199-203 [3] Wu Q, Inman RD, Davis KD. Neuropathic pain in ankylosing spondylitis: a psychophysics and brain imaging study. Arthritis Rheum. 2013;65(6):1494-503 <h3>Disclosure of Interests</h3> None declared