AB0138 UNRAVELLING THE NUANCES OF PAIN IN PRIMARY SJÖGREN’S SYNDROME
Authors: A. Alunno, E. DI Ruscio, S. Cappannari, M. E. Carugno, E. Matone, I. Olivieri, L. Serio, F. M. Mariani, P. Altieri, C. Ferri, F. Carubbi
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Different types of pain are commonly observed in patients with primary Sjögren's syndrome (pSS) such as articular/muscular pain, neuropathic pain and widespread pain. The 0-10 visual analogue scale (VAS) is broadly used to quantify the intensity of pain however, it does not capture the nuances of pain and the impact on the individual quality of life. <h3>Objectives:</h3> To explore the characteristics of pain and how it is affected by different daily activities in patients with pSS. <h3>Methods:</h3> Consecutive patients with pSS according to the ACR-EULAR 2016 classification criteria, without fibromyalgia and with a VAS pain &gt;0 were eligible for inclusion in the study. Patients rated their pain on a 0-10 VAS and then filled the McGill pain questionnaire to describe their pain using up to 78 descriptors across 20 domains. For each domain patients selected the most fitting descriptor (the domain could remain unused if none of the descriptors applied to the pain perceived by the patient). Each descriptor also had a score and the pain score (0-78) was the sum of all selected descriptors. Then patients were requested which activities affected their pain and also to weight their pain on a 1-5 Likert scale according to previous experience (e.g., compared to worst headache/toothache ever had). Additional patient reported outcomes were measured (e.g. VAS dryness) and demographic, clinical, and serological data were also collected. <h3>Results:</h3> Of 167 screened pSS patients, 131 were enrolled in the study. None of the patients used all the 20 domains of the McGill questionnaire and the mean pain score was 35.5 (standard deviation, 13.9). The McGill score was not correlated with age, disease duration and disease activity but was directly correlated with VAS scales for dryness. The domains used by over 80% of patients were those about pressure (punctate and incisive), sensory, dullness, tension, brightness as well as the domains related to the affective component of pain. The two least used domain (40% of patients) were the one about temperature (descriptors: cool/cold/freezing) and fear (descriptors: fearful/frightful/terrifying). Figure 1 shows the choice of descriptors according to the frequency. Sleep or rest as well as mild exercise were reported able to reduce pain by half of the patients whereas damp, weather changes, fatigue and tension were those identified to worsen the pain by 68-81% of patients. 30% of patients reported pain to be worsened by intercourse. <h3>Conclusion:</h3> Although VAS pain is reliable and broadly used in clinical practice and research, multidimensional tools such as the McGill pain questionnaire should be used to better understand the individual's experience of pain and established tailored non-pharmacological strategies (e.g., cognitive behavioural therapy) <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>