Rheumatoid arthritis (RA) is a chronic inflammatory joint disease causing pain and disability. Discordance between inflammatory activity and pain in RA has earlier been reported, and one important psychosocial factor that influences the experience of pain is catastrophizing. Pain catastrophizing involves both cognitive and emotional components of pain perception, and leads the patient to expect the worst. Several studies have shown that pain catastrophizing is important for the pain experience in RA, with no clear correlation to objective clinical parameters.
Patients' perspective, including pain, patient global assessment and fatigue, has increasingly been recognized as an outcome measure for therapies. Catastrophizing may therefor influence disease activity scores in RA and also measurements of response to biologic disease modifying drugs (bDMARD).
Three patients with RA starting bDMARD will we presented through one-year follow-up data from the ULRABIT cohort. The patients reveal different pain catastrophizing levels during the study, and we will explore the impact of catastrophizing on subjective and composite scores, in contrast to objective inflammatory variables such as CRP, swollen joint count or ultrasound synovitis. Further, we will discuss the impact of pain catastrophizing on DAS28 remission, demonstrating the difficulties in reaching remission according to composite scores if there are increased levels of pain catastrophizing.
Patient 1: high level of pain catastrophizing both at baseline and at 12 months.
Patient 2: pain catastrophizer at baseline, but not at 12 months.
Patient 3: neither pain catastrophizer at baseline nor at 12 months.
Disclosure of Interest None declared