AB0750 Analgetic Effect of Nsaids in Chronic Knee Osteoarthritis with A "Clinical" Central Sensitization. (15th July 2016)

• Record Type: Journal Article
• Authors: Turovskaia, E.; Alekseeva, L.; Filatova, E.
• Is Part Of: Annals of the rheumatic diseases. Volume 75(2016)Supplement 2
• Page Start: 1161
• Page End: 1161
• Publication Date: 2016-07-15
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2016-eular.4886
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: NSAIDs are widely used for therapy nociceptive pain in osteoarthritis (OA) patients. But in 27% - 61% case this treatment fails to reduce mean pain levels beyond minimal clinically important thresholds [1]. Recent studies have demonstrated that chronic knee OA mechanisms besides nociceptive pain also include central sensitization (CS) (neuroplastic changes in the posterior horn) [2]. CS characterized with neuropathic (NP) phenomena spontaneous and evoked (34% cases), referred hyperalgesia and neurophysiological changes (low pressure pain threshold). Objectives: to evaluate the efficacy of NSAID in patients with "clinical" CS. Methods: 40 women (age 55±75), II-III grade by Kellgren-Lawrence with chronic knee OA were included. Patients were divided in groups in accordance with the results of neuropathic test DN4 (screening test for CS): patients with positive DN4 (n=11) and patients with negative DN4 (n=29) and accordance with presence of spontaneous NP phenomena (for ex. burning, tingling, current rush): patients with spontaneous NP phenomena (n=29) and patients without spontaneous NP phenomena. Dynamic of OA severity by WOMAC (mm) and pain intensity by VAS (mm) were assessed between groups. Results: There was no difference between sociodemographic factors in groups. Statistically and clinically significant reduction in pain score after one-month treatment (n=20) in patients with negative DN4 score was seen (mean pain relief 26mm vs 17 mm, p<0, 05). Significant decrease of WOMAC from baseline to final evaluation in patients without spontaneous NP phenomena (mean WOMAC redaction 315 mm vs 199 mm, p<0, 05) was demonstrated. Conclusions: Patients with clinical signs of CS have suboptimal pain control. Targeting treatment including anticonvulsants or antidepressants to symptoms of CS in people with OA could lead to benefit. References: Breivik H, Collet B, Ventafridda V, et all, Eur J Pain. 2005; Epub ahead of print. Dieppe PA, Ayis S, Clarke S, Simmons D, Williams S, Fallon 1022 Hochman et al M, et al. Quantitative sensory testing in osteoarthritis of the knee [abstract]. Osteoarthritis Cartilage 2008;16:S204 Disclosure of Interest: None declared