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Comparison of Pain Characteristics in Patients with Rheumatoid Arthritis and Systemic Sclerosis with Particular Reference to Neuropathic Pain Component: Cross-Sectional Study.

OBJECTIVE: To compare characteristics of pain in terms of neuropathic pain and to assess association between neuropathic component and quality of life (QoL) in patients with systemic sclerosis (SSc) and rheumatoid arthritis (RA).

SUBJECTS AND METHODS: Fifty-four patients (47 females, 7 males) with systemic sclerosis and 53 patients (46 females,7 males) with RA were assessed for outcome measures including disease activity, physical functions, mental condition and health related QoL measures (SF-36; Hospital Anxiety and Depression Scale) and pain. Neuropathic pain was assessed by Douleur Neuropathique 4 (DN4) questionnaire and PainDetect questionnaire in this cross-sectional study.

RESULTS: Patients had similar education, smoking status, functioning and HRQoL. However, patients with RA declared more severe visual analogue scale of pain, and higher body mass index than SSc. Neuropathic pain (NeP) component was detected in 42.6% (n = 23) in SSc, and 45.3% (n = 24) in RA (p > 0.05) according to DN4. On PainDetect, possible neuropathic pain was detected in 13.0% (n = 7) vs 15.1% (n = 8), whereas 16.7% (n = 9) vs 17.0% (n = 9) had likely NeP in SSc and RA, respectively (p > 0.05). Most of the neuropathic pain characteristics were similar in SSc and RA except for numbness and painful cold which were notably more common in patients with SSc. Having neuropathic pain component (according to DN4) had no influence on functioning and HRQoL in SSc, however NeP component revealed a heavier burden of disease regarding functional status, HRQoL and psychometric components in RA.

CONCLUSION: The neuropathic pain component was similar between patients with SSc and RA. However neuropathic pain was associated with a heavier burden of disease in patients with RA.

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