The Neuropathic Pain Features in Psoriatic Arthritis: A Cross-sectional Evaluation of Prevalence and Associated Factors

J Rheumatol. 2020 Aug 1;47(8):1198-1203. doi: 10.3899/jrheum.190906. Epub 2019 Dec 1.

Abstract

Objective: To evaluate the prevalence and factors associated with the neuropathic pain features in a cohort of patients with psoriatic arthritis (PsA).

Methods: A cross-sectional evaluation was conducted in consecutive patients having PsA with prevalent peripheral joint involvement, referred to 3 rheumatological centers. For each patient, a comprehensive assessment of disease activity, physical function, and disease effect was carried out. The presence of comorbid fibromyalgia syndrome (FMS) was evaluated. Acute-phase reactants were also recorded. The neuropathic pain features were investigated through the PainDETECT Questionnaire (PDQ). A logistic regression analysis was therefore conducted using the PDQ as the dependent variable.

Results: The final evaluation included 118 patients. A comorbid FMS was detectable in 30 of the 118 patients with PsA (25.4%). Probable characteristics of neuropathic pain (PDQ ≥ 19) were found in 30 (25.4%) patients overall, ambiguous (PDQ > 12 and < 19) in 21 (17.8%) patients, and unlikely (PDQ ≤ 12) in 67 (56.8%) patients. Using logistic regression analysis, the only independent variable among those investigated that could explain the neuropathic pain features was the presence of a comorbid FMS (p = 0.0127). Excluding patients with comorbid FMS, an association with disability (measured by Health Assessment Questionnaire-Disability Index) emerges (p = 0.0489). In patients with PsA and comorbid FMS, PDQ scores were significantly higher than in patients without comorbid FMS.

Conclusion: Neuropathic pain features are common in patients with PsA, and the presence of pain sensitization (comorbid FMS) seems to be its main predictor.

Keywords: FIBROMYALGIA; NEUROPATHIC PAIN FEATURES; PSORIATIC ARTHRITIS.

MeSH terms

  • Arthritis, Psoriatic* / complications
  • Arthritis, Psoriatic* / epidemiology
  • Cross-Sectional Studies
  • Fibromyalgia* / complications
  • Fibromyalgia* / epidemiology
  • Humans
  • Neuralgia* / diagnosis
  • Neuralgia* / epidemiology
  • Prevalence