Journal Article

OP0012-HPR CENTRAL SENSITIZATION HAS MAJOR IMPACT ON DISEASE ACTIVITY, FUNCTIONAL DISABILITY AND FRAILTY IN PATIENTS WITH RA

Spinelli, F. R., Longhino, S., Nacci, F., Salaffi, F., Baldi, C., Perniola, S., Quartuccio, L., Iacono, D., Farah, S., Bazzani, C., Fornaro, M.

2023

Overview

BackgroundCentral sensitization (CS) assessed with Central sensitization Inventory (CSI) is significantly associated with functional disability and frailty in patients with rheumatoid arthritis (RA). Frailty is common in RA and associated with hospitalization and mortality. Frailty in RA is dynamic and, for some, may be ameliorated through controlling disease activity and functional disability.ObjectivesOur aim was to investigate the prevalence of CS in patients with RA and its association with measures of disease activity, functional disability, and frailty.MethodsWe administered to all the subjects in the study the CS inventory (CSI), a questionnaire that has been used for the diagnosis of CS. Demographic and clinical characteristics were collected as well as measures of disease activity [RAID), functional disability (ROAD) and Kihon Checklist (KCL) screening tool to identify community-dwelling adults vulnerable to frailty potentially at risk of becoming dependent. Patients with fibromyalgia were excluded from the study.ResultsOf the 192 included RA patients, mean CSI score was 36.7 ±15.5 and 36.5% scored >40, which indicates a high probability of CS. Mean CDAI score was 16.8 ± 12.4 and mean RAID 5.0 ± 2.0. A CSI score >40 was significantly associated with higher RAID (mean 5.7 vs. 4.6; F-ratio 12.28; p=0.001), higher ROAD (mean 4.3 vs. 3.0; F-ratio 17.37; p<0.001) and higher Kihon score (mean 9.1 vs. 5.7; F-ratio 29.88; p<0.001).ConclusionCS is strongly related to patient-reported disease activity, functional disability and frailty in patients with RA independently from other patient-and disease-related aspects. CS is an important determinant of functional disability in patients with chronic inflammatory arthritides. Therefore, special attention should be paid to RA patients, in whom the concomitant diagnosis of CS should be routinely ruled out.References[1] Chiarotto A, Viti C, Sulli A, Cutolo M, Testa M, Piscitelli D (2018) Cross-cultural adaptation and validity of the Italian version of the Central Sensitization Inventory. Musculoskelet Sci Pract 37:20-28.[2] Salaffi F, Di Matteo A, Farah S, Di Carlo M: Inflammaging and Frailty in Immune-Mediated Rheumatic Diseases: How to Address and Score the Issue. Clin Rev Allergy Immunol 2022; doi: 10.1007/s12016-022-08943-z.[3] Watanabe D, Yoshida T, Watanabe Y, Yamada Y, Miyachi M, Kimura M: Validation of the Kihon Checklist and the frailty screening index for frailty defined by the phenotype model in older Japanese adults. BMC Geriatr 2022; 22:478.[4] Salaffi F, Stancati A, Neri R, Grassi W, Bombardieri S. Measuring functional disability in early rheumatoid arthritis: the validity, reliability and responsiveness of the Recent-Onset Arthritis Disability (ROAD) index. Clin Exp Rheumatol. 2005 Sep-Oct;23(5 Suppl 39):S31-42.Figure 1.Disease activity (RAID score), functional disability (ROAD score) and frailty (Kihon score) in patient with CSI < 40 (n° 122) and CSI > 40 (n° 70).Acknowledgements:NIL.Disclosure of InterestsNone Declared.

• Publisher: BMJ Publishing Group Ltd and European League Against Rheumatism,Elsevier B.V,Elsevier Limited
• Subject: Check lists / Diagnosis / Disease / Fibromyalgia / Frailty / Health Professionals in Rheumatology Abstracts / Inflammation / Outcome measures / Patient reported outcomes / Patients / Phenotypes / Rheumatoid arthritis