Pain is a significant issue in rheumatoid arthritis (RA) and can have a negative impact on patients' quality of life. Despite optimal control of inflammatory disease, residual chronic pain remains a major unmet medical need in RA. Pain in RA can be secondary to inflammation but can also generate neuroendocrine responses that initiate neurogenic inflammation and enhance cytokine release, leading to persistent hyperalgesia. In addition to well-known cytokines such as TNF alpha and IL-6, other cytokines and the JAK-STAT pathway play a role in pain modulation and inflammation. The development of chronic pain in RA involves processes beyond inflammation or structural damage. Residual pain is often observed in patients even after achieving remission or low disease activity, suggesting the involvement of non-inflammatory and central sensitization mechanisms. Moreover, fibromyalgia syndrome (FMS) is prevalent in RA patients and may contribute to persistent pain. Factors such as depression, sleep disturbance, and pro-inflammatory cytokines may contribute to the development of fibromyalgia in RA. It is essential to identify and diagnose concomitant FMS in RA patients to better manage their symptoms. Further research is needed to unravel the complexities of pain in RA. Finally, recent studies have shown that JAK inhibitors effectively reduce residual pain in RA patients, suggesting pain-reducing effects in-dependent of their anti-inflammatory properties.

Residual pain in rheumatoid arthritis: Is it a real problem? / P. Sarzi-Puttini, M. Zen, F. Arru, V. Giorgi, E.A. Choy. - In: AUTOIMMUNITY REVIEWS. - ISSN 1568-9972. - 22:11(2023 Nov), pp. 103423.1-103423.5. [10.1016/j.autrev.2023.103423]

Residual pain in rheumatoid arthritis: Is it a real problem?

P. Sarzi-Puttini
Primo
;
2023

Abstract

Pain is a significant issue in rheumatoid arthritis (RA) and can have a negative impact on patients' quality of life. Despite optimal control of inflammatory disease, residual chronic pain remains a major unmet medical need in RA. Pain in RA can be secondary to inflammation but can also generate neuroendocrine responses that initiate neurogenic inflammation and enhance cytokine release, leading to persistent hyperalgesia. In addition to well-known cytokines such as TNF alpha and IL-6, other cytokines and the JAK-STAT pathway play a role in pain modulation and inflammation. The development of chronic pain in RA involves processes beyond inflammation or structural damage. Residual pain is often observed in patients even after achieving remission or low disease activity, suggesting the involvement of non-inflammatory and central sensitization mechanisms. Moreover, fibromyalgia syndrome (FMS) is prevalent in RA patients and may contribute to persistent pain. Factors such as depression, sleep disturbance, and pro-inflammatory cytokines may contribute to the development of fibromyalgia in RA. It is essential to identify and diagnose concomitant FMS in RA patients to better manage their symptoms. Further research is needed to unravel the complexities of pain in RA. Finally, recent studies have shown that JAK inhibitors effectively reduce residual pain in RA patients, suggesting pain-reducing effects in-dependent of their anti-inflammatory properties.
Chronic pain; Fibromyalgia; Nociception; Residual pain; Rheumatoid arthritis; Sensitization
Settore MED/16 - Reumatologia
nov-2023
Article (author)
File in questo prodotto:
File Dimensione Formato  
1-s2.0-S156899722300157X-main.pdf

accesso riservato

Descrizione: Article
Tipologia: Publisher's version/PDF
Dimensione 427.95 kB
Formato Adobe PDF
427.95 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1032061
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 10
  • ???jsp.display-item.citation.isi??? 7
social impact