在评估类风湿性关节炎活动时,残留疼痛的问题
Gabriela Motyl1,2, Wiktoria Maria Krupka1,2, Maria Maślińska3
1Medical University of Warsaw, Poland.
Reumatologia
|July 26, 2024
概括
类风湿性关节炎 (RA) 的残留疼痛显著影响生活质量. 需要新的评估方法来解决炎症和非炎症性疼痛机制,超出目前的疾病活动措施.
科学领域:
- 类风湿病学 类风湿病学
- 疼痛医学 医学 疼痛医学
- 临床研究 临床研究
背景情况:
- 剩余疼痛是类风湿性关节炎 (RA) 患者的重要未满足需求,尽管疾病缓解或疾病活性较低,但仍然存在.
- 这种持续的疼痛会对患者的生活质量产生负面影响.
- 当前的疾病活动措施可能无法充分捕捉或解决残留疼痛.
研究的目的:
- 阐明RA残留疼痛的复杂病理生理机制,包括炎症性,神经病变性和鼻膜性疼痛.
- 识别导致残留疼痛的骨关节炎和纤维肌痛等二次疼痛综合征.
- 突出现有的欧洲风湿病学协会联盟 (EULAR) 和美国风湿病学学院 (ACR) 疾病活动评估在疼痛评估方面的局限性.
主要方法:
- 审查有关RA病理生理学和疼痛机制的当前文献.
- 分析现有的疾病活动指标及其在评估疼痛方面的缺陷.
- 在RA患者中探索差异性疼痛诊断的潜在方法.
主要成果:
- 残留疼痛涉及多种机制,包括炎症,神经病变和nociplastic组成部分.
- 二次性疾病如骨关节炎和纤维肌痛可以加剧RA的残留疼痛.
- 目前的EULAR和ACR指南在全面评估疼痛方面存在局限性,需要单独的评估工具.
结论:
- 对RA患者来说,对疼痛的独特评估至关重要,独立于整体疾病活动.
- 开发有效的疼痛评估方法对于识别特定的疼痛病理机制至关重要.
- 基于个体疼痛机制的量身定制治疗是有效管理RA残留疼痛的必要条件.
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