Hammer HB, et al. – The experts aimed to figure out how pain catastrophizing was related to patient–reported outcomes (PROs), composite scores and assessments of inflammatory activity in rheumatoid arthritis (RA) patients. Their investigations revealed that Pain catastrophizing was strongly associated with PROs and composite measures, but not markers of inflammation. They suggested that the high levels of pain catastrophizing reduced the likelihood of achieving composite score remission and should be considered in a treatment strategy.

Methods

• In this study, RA patients starting bDMARD were examined at baseline and after 1, 2, 3, 6 and 12 months with PROs (joint pain/patient's global VAS, MHAQ, RAID score), clinical and laboratory assessments (tender/swollen joint count, assessor's global VAS, ESR/CRP), ultrasound (US) (grey scale/power Doppler of 36 joints and 4 tendons) and pain catastrophizing.
• The composite scores DAS28, CDAI and SDAI were calculated.
• Statistical calculations included independent samples T–test, paired samples T–test, one–way ANOVA, Pearson's correlations, linear and logistic regression.

Results

• Out of 209 patients included, 152 (72.7%) completed 12 months follow–up.
• Investigations revealed that pain catastrophizing, PROs, clinical and inflammatory assessments decreased significantly (p<0.001).
• Pain catastrophizing was strongly correlated with the PROs and composite scores (p<0.001) but not with the inflammatory parameters (swollen joint count, CRP, GS/PD US).
• Patients with higher levels of pain catastrophizing had higher PROs and composite scores during the study (p<0.001) but not inflammatory assessments.
• Findings displayed that baseline pain catastrophizing was negatively associated with achievement of remission at 6 and 12 months (p<0.05).