AB0917 HOW CENTRAL SENSITIZATION CAN AFFECT QUALITY OF LIFE AND THERAPEUTIC RESPONSE IN SPONDYLOARTHRITIS: A MONOCENTRIC COHORT ANALYSIS
Authors: F. Fattorini, L. Carli, C. Cigolini, L. Esti, M. DI Battista, M. Mosca, A. Delle Sedie
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Spondyloarthritis (SpA) is a group of systemic autoimmune diseases, mainly affecting musculoskeletal system, with typical axial or peripheral forms. Central sensitization (CS) has been held responsible for both persistent pain and high disease activity score in SpA [1]. Central Sensitization Inventory (CSI) is a questionnaire used to determine CS frequency: a score of at least 40 is associated with a high likelihood of CS. <h3>Objectives:</h3> To investigate the prevalence of CS in our cohort and its association with clinical characteristics of patients and patient-reported outcomes (PROs) measures. <h3>Methods:</h3> Adult patients with a diagnosis of Psoriatic Arthritis (PsA) or Axial Spondyloarthritis (AxSpA) according to CASPAR (ClASsification criteria for Psoriatic Arthritis) and ASAS (Assessment of SpondyloArthritis international Society) criteria respectively, regularly followed at the SpA out-patients clinic of our Unit, were consecutively enrolled from April to November 2023. Their epidemiologic, clinic and clinimetric data were collected, as well as PROs [CSI, Health Assessment Questionnaire (HAQ), FACIT-Fatigue (FACIT-F), SHORT-FORM 36 (SF-36), Hospital Anxiety and Depression Scale (HADS)]. Taking into account the definition of a "difficult to treat" rheumatoid arthritis [2], we defined as "multi-failure" those patients who were treated with more than 3 disease modifying anti-rheumatic drugs (DMARDs). Intergroups comparisons were assessed by using Chi-square, t-test and ANOVA. P values &lt;0.05 were considered significant. <h3>Results:</h3> A total of 99 patients were enrolled, 46 male (46.5%) and 53 female (53.5%) with a mean age of 59,4±9.8 years and a mean disease duration of 14.8±10.1 years; 78 patients (78.8%) had a diagnosis of PsA and 21 (21.2%) of axSpA. Forty-one patients (41.4%) had a CSI score ≽40. Significant correlations were found among CSI score ≽40 and female sex (p=0.004), fibromyalgia (FM) (p=0.004), thyroid disease (p=0.016), obesity (p=0.047) and with a multi-failure condition (p=0.013). Regarding PROs, significant correlations were found between CSI and values of HADS (both anxiety and depression), FACIT-F, HAQ and all the domains of SF-36 (p value &lt;0.0001). In the multivariate analysis, the CSI score remained significantly associated with multi-failure patients (p=0.02), female sex (p=0.01), HAQ (p=0.005) and PGA (p=0.03). <h3>Conclusion:</h3> CS is frequent in our cohort, and it seems to significantly affect quality of life in patients with SpA. As expected, we observed CS was associated with a perception of a higher disease activity from patients. Moreover, our data highlighted an association among CS and female sex, a compromised quality of life and a multi-failure condition. It was interesting to note how the association with FM was lost in the multivariate setting. Further studies are needed to better clarify if CS is a cause or the consequence of those factors. <h3>REFERENCES:</h3> [1] Aykurt Karlibel I, Kasapoğlu Aksoy M. Ir J Med Sci. 2023;192(1):481-489. PMID: 35226249. [2] Nagy G, Roodenrijs NMT, Welsing PM, Kedves M, Hamar A, van der Goes MC, Kent A et al. Ann Rheum Dis. 2021;80(1):31-35. PMID: 33004335 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>