Risk factors for pain in people with rheumatoid arthritis

What is it about?

Background Rheumatoid arthritis is a painful inflammatory condition that affects the joints and can lead to severe disability. One of the major worries for people with rheumatoid arthritis is the amount of pain that they experience. Anti-TNF biologic drugs, such as Embrel, are currently the best options for managing inflammation in people with rheumatoid arthritis. Aim of the study This study looked for risk factors for experiencing worse pain one year after starting a new treatment for rheumatoid arthritis. It also examined whether these factors were related to stopping or changing biologic treatment. How the study was carried out We used the research database from the British Society for Rheumatology Biologics Register and examined data from more than 15000 people.who were given the usual care for rheumatoid arthritis. Some were starting anti-TNF drugs while others were starting other treatments. The levels of pain at the start and at one year, were examined. The decision to change the first anti-TNF drug was also noted during this year. What the study found At the start of the study, the pain was widespread. However, even after one year of effective treatments, there were many people still experiencing pain. Half of the people who were thought to respond well to treatment said that their pain levels were problematic. We looked at the factors that were associated with having worse pain and found several factors that appeared to be linked to it. One of these factors was a unique measure that contrasted arthritis symptoms to levels of inflammation; , and this may give us clues about how to split people into groups that are likely to experience different pain. We also found that pain levels at the start of the study, gender, being overweight, disability levels, psychological health and having other medical conditions, were also associated with worse pain levels. Significance of the study to Pain Centre’s research This study implies that pain relief is an unmet need for people with rheumatoid arthritis. It may be possible to split people into groups that are likely to feel worse pain. If this could be achieved, then pain treatments could be directed to those people who are more likely to gain a benefit from them.

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Why is it important?

Key findings and importance of the study Anti-TNF biologic drugs are currently the best options for managing inflammation in people with RA. However, one year after beginning treatment with anti-TNF biologic drugs many people still feel appreciable levels of pain. Even those people who responded well to the treatment will often say that they feel a lot of pain. Our findings suggest that some people with rheumatoid arthritis are susceptible to feel worse pain. People with worse pain at the start of the study were more likely to change their medications.

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