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Anales del Sistema Sanitario de Navarra
versão impressa ISSN 1137-6627
Resumo
MONFORTE-GASQUE, María Pilar et al. Assessment of pain in patients with rheumatic disease under biological therapy treatment. Anales Sis San Navarra [online]. 2022, vol.45, n.3, e1020. Epub 24-Abr-2023. ISSN 1137-6627. https://dx.doi.org/10.23938/assn.1020.
Background:
To assess pain in patients with rheumatic disease under biological therapy treatment.
Methods:
Observational retrospective study of patients with rheumatic disease under biological therapy treatment who visited the health care center as outpatients in February/August 2020. We collected demographic (sex and age), clinical (diagnosis, pain presence, intensity, and location), and pharmacological (biolo-gical therapy, concomitant treatment with traditional DMARDs, and analgesic treatment) variables from the electronic medical records and Farmatools Dominion®.
Results:
We included 138 patients; mean age was 56 years and 71% were female. The most frequent diagnosis (47%) was ankylosing spondylitis. Anti-TNF-α was the most prescribed biological drug (64%); 60.1% of study patients received traditional drugs, particularly methotrexate and leflunomide (51.8 and 28.9%, respectively). Pain was reported in 81% of the cases, particularly in hands (73.2%) and knees (69.6%); mean pain intensity was 6.5 (VAS). Although 83.3% of the patients had been prescribed analgesics, pain persisted in 84.8% of the cases (VAS >4), being severe or very severe in 67.9%. Over half of the patients (52.2%) used more than one analgesic. The most frequently prescribed medications were non-steroidal anti-inflammatory drugs (NSAIDs) (60%), paracetamol (52.2%), and opioids (56.5%). NSAIDs controlled pain (14.5%) better than opioids (8.3%); there was no post-treatment improvement of pain in 29.6% of the patients. The number of prescribed drugs increased with pain intensity (rho = 0.264; p = 0.006).
Conclusion:
Almost 70% of study patients had uncontrolled severe rheumatic-related pain. This implies a challenge for esta-blishing effective treatments for this type of pain.
Palavras-chave : Rheumatic diseases; Pain; Biological therapies; Analgesics.