Abstract
Ankylosing Spondylitis(AS) is a common chronic inflammatory rheumatological disease. It is known that neuropathic pain, as well as inflammatory pain, increases in rheumatic diseases. In our study, we aimed to investigate the presence of neuropathic pain in AS patients, which we frequently encounter in clinical practice. 52 AS patients were included in the study. HLA-B27 genetic test results, c-reactive protein, and erythrocyte sedimentation rate values of the people included in the study were recorded. LANSS pain scale was applied to all participants to determine neuropathic pain, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was applied to evaluate disease activity. The average age of the individuals participating in the study was 42.57. According to the results of the LANSS pain scale, neuropathic pain was detected in 24 (46.2%) of the individuals. According to BASDAI results, 61.5% of the patients had active disease. A statistically significant relationship was detected between active disease and neuropathic pain (p = 0.001). It was concluded that neuropathic pain may accompany the clinic in a large proportion of patients with AS. We believe that detailed questioning of neuropathic complaints in these patients and treatment if necessary will contribute positively to the quality of life of the patients, and excessive anti-inflammatory treatment can be prevented by reducing the levels of disease activity scales, some of which cannot be evaluated very objectively.
References
- Alkan, H., Ardic, F., Erdogan, C., Sahin, F., Sarsan, A., & Findikoglu, G. (2013). Turkish version of the painDETECT questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Medicine, 14(12), 1933-1943. https://doi.org/10.1111/pme.12222
- Choi, J. H., Lee, S. H., Kim, H. R., & Lee, K. A. (2018). Association of neuropathic-like pain characteristics with clinical and radiographic features in patients with ankylosing spondylitis. Clinical rheumatology, 37(11), 3077–3086. https://doi.org/10.1007/s10067-018-4125-z
- Clauw, D. J., & Witter, J. (2009). Pain and rheumatology: thinking outside the joint. Arthritis and rheumatism, 60(2), 321–324. https://doi.org/10.1002/art.24326
- Garip, Y., Filiz, E. S. E. R., KILIÇARSLAN, A., & Bodur, H. (2015). Prevalence of neuropathic pain in rheumatic disorders: association with disease activity, functional status and quality of life. Archives of Rheumatology, 30(3), 231-237. 10.5606/ArchRheumatol.2015.5295
- Geler-Külcü, D., Batıbay, S., Öztürk, G., & Mesci, N. (2018). The association of neuropathic pain and disease activity, functional level, and quality of life in patients with ankylosing spondylitis: a cross-sectional study. Turkish journal of medical sciences, 48(2), 257–265. https://doi.org/10.3906/sag-1707-147
- Gok, K., Cengiz, G., Erol, K., & Ozgocmen, S. (2018). Neuropathic Pain Component in Axial Spondyloarthritis and the Influence on Disease Burden. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 24(6), 324–327. https://doi.org/10.1097/RHU.0000000000000711.
- Kim, T. W., Son, S. M., & Lee, J. S. (2020). Neuropathic pain in ankylosing spondylitis: a meta-analysis. Neuropathischer Schmerz bei ankylosierender Spondylitis – eine Metaanalyse. Zeitschrift fur Rheumatologie, 79(1), 95–102. https://doi.org/10.1007/s00393-019-0654-3
- Lee, Y. C., Nassikas, N. J., & Clauw, D. J. (2011). The role of the central nervous system in the generation and maintenance of chronic pain in rheumatoid arthritis, osteoarthritis and fibromyalgia. Arthritis research & therapy, 13(2), 211. https://doi.org/10.1186/ar3306
- Mesci, E., Mesci, N., Madenci, E., & Kadıoğlu, A. İ. (2015). Ankilozan spondilitli hastalarda nöropatik ağrı. Boğaziçi Tip Dergisi.
- Rudwaleit, M., Haibel, H., Baraliakos, X., Listing, J., Märker-Hermann, E., Zeidler, H., Braun, J., & Sieper, J. (2009). The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis and rheumatism, 60(3), 717–727. https://doi.org/10.1002/art.24483
- Schaible, H. G., Ebersberger, A., & Von Banchet, G. S. (2002). Mechanisms of pain in arthritis. Annals of the New York Academy of Sciences, 966, 343–354. https://doi.org/10.1111/j.1749-6632.2002.tb04234.x
- van der Linden, S., Valkenburg, H. A., & Cats, A. (1984). Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis and rheumatism, 27(4), 361–368. https://doi.org/10.1002/art.1780270401
- Wu, Q., Inman, R. D., & Davis, K. D. (2013). Neuropathic pain in ankylosing spondylitis: a psychophysics and brain imaging study. Arthritis and rheumatism, 65(6), 1494–1503. https://doi.org/10.1002/art.37920
- Yucel, A., Senocak, M., Kocasoy Orhan, E., Cimen, A., & Ertas, M. (2004). Results of the Leeds assessment of neuropathic symptoms and signs pain scale in Turkey: a validation study. The journal of pain, 5(8), 427–432. https://doi.org/10.1016/j.jpain.2004.07.001
- Zardi, E. M., Pipita, M. E., Giorgi, C., Afeltra, A., Maffulli, N., & Franceschi, F. (2019). Strain Ultrasound Elastography in the Achilles Tendon of Ankylosing Spondylitis Patients Treated With Anti-TNF-α: A Preliminary Study. In vivo (Athens, Greece), 33(5), 1635–1640. https://doi.org/10.21873/invivo.11648
- Zochling, J. (2011). Measures of symptoms and disease status in ankylosing spondylitis: ankylosing spondylitis disease activity score (ASDAS), ankylosing spondylitis quality of life scale (ASQoL), bath ankylosing spondylitis disease activity index (BASDAI), bath ankylosing spondylitis functional index (BASFI), bath ankylosing spondylitis global score (BAS‐G), bath ankylosing spondylitis metrology index (BASMI), Dougados functional index (DFI), and health assessment questionnaire for the spondylarthropathies (HAQ‐S). Arthritis care & research, 63(S11), S47-S58. https://doi.org/ 10.1002/acr.20575.
Abstract
Ankilozan Spondilit(AS) kronik inflamatuvar sık görülen bir romatolojik hastalıktır. Romatolojik hastalıklarda inflamatuvar ağrının yanı sıra nöropatik ağrının da arttığı bilinmektedir. Biz çalışmamızda klinik pratikte sıkça karşılaştığımız AS hastalarında nöropatik ağrı varlığını araştırmayı amaçladık. Çalışmaya 52 AS hastası dahil edildi. Çalışmaya dahil edilen kişilerin HLA-B27 genetik test sonucu, c-reaktif protein, eritrosit sedimentasyon hızı değerleri kaydedildi. Tüm katılımcılara nöropatik ağrıyı belirlemek için LANSS ağrı skalası, hastalık aktivitesini değerlendirmek için Bath Ankilozan Spondilit Hastalık Aktivite İndeksi(BASDAİ) uygulandı. Çalışmaya katılan bireylerin yaş ortalaması 42.57’di. LANSS ağrı skalası sonuçlarına göre bireylerin 24’ünde(%46.2) nöropatik ağrı tespit edildi. BASDAİ sonuçlarına göre hastaların %61.5’i aktif hastalığa sahipti. Aktif hastalık ile nöropatik ağrı arasında istatistiksel olarak anlamlı bir ilişki saptandı(p=0.001). AS hastalarında büyük oranda nöropatik ağrının kliniğe eşlik edebileceği sonucuna varıldı. Bu hastalarda nöropatik şikayetlerin ayrıntılı sorgulanmasının ve gerekirse tedavi edilmesinin hastaların yaşam kalitesine olumlu yönde katkı yapacağı ve bir kısmı çok da objektif olarak değerlendirilemeyen hastalık aktivite ölçeklerinin düzeylerinde azalma görülerek aşırı anti-inflamatuvar tedavinin de engellenebileceği kanaatindeyiz.
References
- Alkan, H., Ardic, F., Erdogan, C., Sahin, F., Sarsan, A., & Findikoglu, G. (2013). Turkish version of the painDETECT questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Medicine, 14(12), 1933-1943. https://doi.org/10.1111/pme.12222
- Choi, J. H., Lee, S. H., Kim, H. R., & Lee, K. A. (2018). Association of neuropathic-like pain characteristics with clinical and radiographic features in patients with ankylosing spondylitis. Clinical rheumatology, 37(11), 3077–3086. https://doi.org/10.1007/s10067-018-4125-z
- Clauw, D. J., & Witter, J. (2009). Pain and rheumatology: thinking outside the joint. Arthritis and rheumatism, 60(2), 321–324. https://doi.org/10.1002/art.24326
- Garip, Y., Filiz, E. S. E. R., KILIÇARSLAN, A., & Bodur, H. (2015). Prevalence of neuropathic pain in rheumatic disorders: association with disease activity, functional status and quality of life. Archives of Rheumatology, 30(3), 231-237. 10.5606/ArchRheumatol.2015.5295
- Geler-Külcü, D., Batıbay, S., Öztürk, G., & Mesci, N. (2018). The association of neuropathic pain and disease activity, functional level, and quality of life in patients with ankylosing spondylitis: a cross-sectional study. Turkish journal of medical sciences, 48(2), 257–265. https://doi.org/10.3906/sag-1707-147
- Gok, K., Cengiz, G., Erol, K., & Ozgocmen, S. (2018). Neuropathic Pain Component in Axial Spondyloarthritis and the Influence on Disease Burden. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 24(6), 324–327. https://doi.org/10.1097/RHU.0000000000000711.
- Kim, T. W., Son, S. M., & Lee, J. S. (2020). Neuropathic pain in ankylosing spondylitis: a meta-analysis. Neuropathischer Schmerz bei ankylosierender Spondylitis – eine Metaanalyse. Zeitschrift fur Rheumatologie, 79(1), 95–102. https://doi.org/10.1007/s00393-019-0654-3
- Lee, Y. C., Nassikas, N. J., & Clauw, D. J. (2011). The role of the central nervous system in the generation and maintenance of chronic pain in rheumatoid arthritis, osteoarthritis and fibromyalgia. Arthritis research & therapy, 13(2), 211. https://doi.org/10.1186/ar3306
- Mesci, E., Mesci, N., Madenci, E., & Kadıoğlu, A. İ. (2015). Ankilozan spondilitli hastalarda nöropatik ağrı. Boğaziçi Tip Dergisi.
- Rudwaleit, M., Haibel, H., Baraliakos, X., Listing, J., Märker-Hermann, E., Zeidler, H., Braun, J., & Sieper, J. (2009). The early disease stage in axial spondylarthritis: results from the German Spondyloarthritis Inception Cohort. Arthritis and rheumatism, 60(3), 717–727. https://doi.org/10.1002/art.24483
- Schaible, H. G., Ebersberger, A., & Von Banchet, G. S. (2002). Mechanisms of pain in arthritis. Annals of the New York Academy of Sciences, 966, 343–354. https://doi.org/10.1111/j.1749-6632.2002.tb04234.x
- van der Linden, S., Valkenburg, H. A., & Cats, A. (1984). Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis and rheumatism, 27(4), 361–368. https://doi.org/10.1002/art.1780270401
- Wu, Q., Inman, R. D., & Davis, K. D. (2013). Neuropathic pain in ankylosing spondylitis: a psychophysics and brain imaging study. Arthritis and rheumatism, 65(6), 1494–1503. https://doi.org/10.1002/art.37920
- Yucel, A., Senocak, M., Kocasoy Orhan, E., Cimen, A., & Ertas, M. (2004). Results of the Leeds assessment of neuropathic symptoms and signs pain scale in Turkey: a validation study. The journal of pain, 5(8), 427–432. https://doi.org/10.1016/j.jpain.2004.07.001
- Zardi, E. M., Pipita, M. E., Giorgi, C., Afeltra, A., Maffulli, N., & Franceschi, F. (2019). Strain Ultrasound Elastography in the Achilles Tendon of Ankylosing Spondylitis Patients Treated With Anti-TNF-α: A Preliminary Study. In vivo (Athens, Greece), 33(5), 1635–1640. https://doi.org/10.21873/invivo.11648
- Zochling, J. (2011). Measures of symptoms and disease status in ankylosing spondylitis: ankylosing spondylitis disease activity score (ASDAS), ankylosing spondylitis quality of life scale (ASQoL), bath ankylosing spondylitis disease activity index (BASDAI), bath ankylosing spondylitis functional index (BASFI), bath ankylosing spondylitis global score (BAS‐G), bath ankylosing spondylitis metrology index (BASMI), Dougados functional index (DFI), and health assessment questionnaire for the spondylarthropathies (HAQ‐S). Arthritis care & research, 63(S11), S47-S58. https://doi.org/ 10.1002/acr.20575.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Rheumatology and Arthritis |
| Journal Section | Research Article |
| Authors | |
| Early Pub Date | April 29, 2024 |
| Publication Date | April 30, 2024 |
| Submission Date | March 22, 2024 |
| Acceptance Date | April 16, 2024 |
| Published in Issue | Year 2024Volume: 9 Issue: 1 |
