AB0683 OSTEOARTHRITIS PAIN AND COVID-19 PANDEMIC: THE LOCKDOWN IMPACT
Authors: F. Orsini, O. De Lucia, F. Ingegnoli, G. Cincinelli, G. Armentaro, R. DI Taranto, R. Caporali
Journal: Annals of the Rheumatic Diseases (2021)

Background: Both peripheral and central nervous system processes are involved in osteoarthritis (OA) pain. Several aspects such as environmental, psychological and constitutional factors contribute to OA pain and they were enhanced during and after lockdown, for COVID-19 pandemic. Objectives: The purpose of this study is to assess the impact of the modified lifestyle forced by lockdown on joint pain using Visual Analogic Scale (VAS) scale. the variation of VAS pain, the reduction of physical activity, the variation of body weight, the stress values defined by Perceived Stress Scale (PSS) and the use of anxiolytics and antidepressant drugs were measured in OA patiens during the lockdown period. Methods: 74 adult patients affected by primary or secondary OA were included. The median age was 69.8 years old and 55/74 (74%) of the patients were female. Sex, age, comorbidities, pharmacological therapy, variation rate of VAS pain referred to OA symptoms (0-100) during lockdown, weight variation, degree of physical activity (defined as: absent 0 h, low 1-5 h, moderate 6-10 h, high &gt; 10 h) were recorded. Perceived stress using PSS was recorded and patients were divided into two classes: low (0-13) or moderate-high (14-40) stress scale. This observational retrospective real-life study was conducted in May 2020. A linear regression model was used to analyze the different patients groups separately. Overall variables were expressed on analogic scales. To assess the impact on VAS pain, regression models were estimated with VAS pain as dependent variable, and weight increase, physical activity and perceived stress as independent variable. Results: Patients enrolled with a pre lockdown VAS pain &lt; 40 were 30, whereas 44 patients referred a pre lockdown VAS pain &gt; 40. Patients taking anxiolytics, antidepressant, anxiolytics or antidepressant drugs were 14/74 (19%), 7/74 (9%), 19/74 (26%) respectively. PSS score Low (score 0-13), Med (score 14-26), High (score 27-40) was recorded in 34/74 (46%), 36/74 (49%), 4/74 (5%) patients respectively. Patients were divided in two different groups on the basis of baseline pre lockdown VAS pain: low VAS pain (&lt; 40) (n=30) and moderate-high (≥ 40) (n=44). In the low-VAS group there was an average increase of pain by 1,36 points, an average increase of weight by 0.63 kg, and an average decrease of weekly physical activity by 6.4 hours that was statistically relevant (p&lt; 0.0001). In moderate-high VAS group an average increase of pain and weight, by 2.62 points and 0.35 kg respectively, and a significant decrease of physical activity by 3.15 h weekly (p&lt; 0.0001) has been recorded In low VAS group, 43% of the patients perceived low stress values vs 57% moderate-high. In VAS &gt; 40 group 47% of the patients perceived low stress value vs 53% high-moderate. 80% of low- VAS &lt;group did not take anxiolytics and antidepressant drugs and for this cluster of patients was not recorded a VAS increase regardless of PSS. 16.7% of patients (5/30) with VAS &lt; 40, taking anxiolytics / antidepressant medications and with a moderate-high PSS displayed an average increase of VAS pain by 20 mm. In the VAS &gt; 40 group a VAS variation was not recorded, regardless of taking anxiolytics / antidepressant medications and PSS. Conclusion: Lockdown impact on OA pain has been higher in the cluster of patients who were taking anxiolytics / antidepressant drugs with a moderate-high PSS. VAS pain increase in this cluster of patients exceeds minimal clinically relevant difference reported in literature 1 . A relevant physical activity decrease which might negatively impact on OA course has also been recorded. References: [1]Hawker G. et al. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken), 2011. Disclosure of Interests: Francesco Orsini: None declared, Orazio De Lucia: None declared, Francesca Ingegnoli: None declared, Gilberto Cincinelli: None declared, GIUSEPPE ARMENTARO: None declared, Raffaele Di Taranto: None declared, Roberto Caporali Speakers bureau: Abbvie, Amgen, BMS, Celltrion, Galapagos, Gilead, Lilly, Pfizer, Roche, UCB, Sanofi, Fresenius Kabi, Samsung bioepis, MSD, Consultant of: Galapagos, Gilead, Lilly, Janssen, MSD