AB0926 PAIN CATASTROPHIZING NEGATIVELY IMPACTS DRUG RETENTION RATE IN PATIENTS WITH PSORIATIC ARTHRITIS AND AXIAL SPONDYLOARTHRITIS: RESULTS FROM A 2-YEAR PERSPECTIVE MULTICENTER STUDY
Authors: D. Currado, F. Saracino, A. Marino, P. Ruscitti, I. Pantano, M. Vomero, E. Corberi, F. Trunfio, L. Kun, O. Berardicurti, V. Pavlych, C. DI Vico, F. Caso, L. Costa, M. Tasso, F. Camarda, F. Misceo, F. De Vincenzo, A. Corrado, F. P. Cantatore, F. Perosa, G. Guggino, R. Scarpa, P. Cipriani, F. Ciccia, L. Navarini, R. Giacomelli
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Chronic pain and inflammation are common features of rheumatic conditions such as Psoriatic Arthritis (PsA) and Axial Spondyloarthritis (axSpA), often necessitating prolonged medication use for effective management. Maintaining drug retention is essential for achieving disease control and improving patients' quality of life. In recent years, several studies have turned their attention to real-world scenarios, examining the extended-term usage of biologic disease-modifying antirheumatic drugs (bDMARDs) in spondyloarthritis; furthermore, the factors linked to the retention rate of bDMARDs in remain a pivotal question to be addressed. <h3>Objectives:</h3> This study investigates the influence of pain catastrophizing, a psychological response to pain, on the drug retention rates of PsA and axSpA patients. <h3>Methods:</h3> A two-year prospective multicenter observational study involved 135 PsA and 71 axSpA patients. To assess the drug discontinuation rate, any occurrence of withdrawal therapy and adverse events recognized or suspected as linked to therapies were recorded. Pain Catastrophizing, including its domains of Helplessness, Rumination, and Magnification, was assessed using the Pain Catastrophizing Scale (PCS). Univariable and multivariable regression analyses were utilized to identify factors associated with drug retention. <h3>Results:</h3> In the PsA group, patients who discontinued therapy early had higher baseline disease activity and a higher incidence of comorbid fibromyalgia. Notably, pain catastrophizing, specifically the domains of Helplessness, Magnification, and Rumination, were significantly elevated in PsA patients who interrupted their treatment. The univariable linear regression (Table 1) confirmed fibromyalgia comorbidity, corticosteroids assumption, Disease Activity for Psoriatic Arthritis (DAPSA) at baseline and PC levels as predictors for drug suspension within two years follow-up. Of note, the multivariable logistic regression (model adjusted for age, sex, DAPSA and corticosteroids use) showed significant relationship between PsA participants drug discontinuation and PCS (OR 1.04, 95% CI 1.004- 1.074, p=0.02), helplessness (OR 1.09, 95% CI 1.01-1.18, p=0.03), rumination (OR 1.10, 95% CI 1.01- 1.20), but not for magnification domain (OR1.15, 95% CI 0.97-1.36, p=0.09). In axSpA, drug discontinuation was more frequent among females, those with shorter disease duration, higher baseline disease activity, and elevated levels of pain catastrophizing. Of note, the univariable logistic regression (Table 2) established female gender, baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), PCS and all its components helplessness, magnification, and rumination as disease predictor of treatment suspension before two years follow-up. However, limited events in axSpA patients precluded a multivariate analysis. <h3>Conclusion:</h3> Pain catastrophizing has emerged as a significant factor affecting drug retention in PsA and axSpA patients. The findings from the study discussed here shed light on the importance of assessing and addressing pain catastrophizing in clinical practice. By recognizing and intervening in the psychological aspects of pain, healthcare providers can contribute to better outcomes for patients with PsA and axSpA, ultimately improving their quality of life and overall well-being. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>