Якість життя у хворих на ревматоїдний артрит: зв’язок з центральною сенситизацією

Central sensitization (CS) is an important phenomenon that modifies the rheumatoid arthritis (RA) course, reduces the functional capabilities of patients and worsens the quality of patient’s life. The objective: to assess the impact of CS on the quality of life in patients with RA. Materials and methods. 127 patients with RA were clinically examined, whose average age was 52.3 ± 11.7 years, and the duration of the disease was on average 8.8 ± 7.2 years. RA activity was assessed using the DAS-28, SDAI and CDAI indices, and the intensity of the pain syndrome was assessed using a visual analogue scale. Functional capabilities were determined using the HAQ-DI questionnaire. The Short Form-36 (SF-36) questionnaire was used to assess quality of life (QOL). The presence of CS was determined using the validated and cross-culturally adapted Ukrainian version of the Central Sensitization Inventory (CSI). Results. It was found that RA patients with CS had significantly worse QOL indices compared to RA patients without CS. The overall physical component summary (PCS) score in patients without CS was 57.8 ± 18.4, while in patients with CS this value was 32.7 ± 15.8 (p < 0.01). The study revealed significant differences between the groups of RA patients with and without CS in the mental component summary (MCS) scores, namely: 60.8±16.9 versus 39.8 ± 16.4 (p < 0.01). The results obtained from the SF-36 questionnaire demonstrate that RA patients with CS have significantly worse PCS indicators compared to patients without CS on all components of the scale: physical functioning – 62.8 ± 16.2 vs. 39.3 ± 15.1 (p < 0.01), role physical – 59.3 ± 26.1 vs. 31.7 ± 22.1 (p < 0.01), bodily pain – 56.5 ± 21.6 vs. 32.2 ± 18.9 (p < 0.01), general health – 52.7 ± 19.1 vs. 27.9 ± 14.7 (p < 0.01). Similar results were observed for all components of the QOL: mental health – 61.4 ± 18.4 vs. 42.9 ± 14.6 (p < 0.01), role emotional – 59.3 ± 22.1 vs. 38.2 ± 27.6 (p < 0.01), social functioning – 61.9 ± 23.7 vs. 39.8 ± 22.2 (p < 0.01), vitality – 60.7 ± 16.2 vs. 38.7 ± 15.1 (p < 0.01). The results of the study indicate significant inverse correlations between QOL and indicators of RA activity, severity of pain syndrome and functional ability of patients, as well as with indicators of the CSI questionnaire. Conclusions. The study found that CS has a significant impact on QOL in RA patients and is associated with age, disease duration, RA activity, and changes in patients’ functional capabilities. CS may be a predictor of rapid deterioration of QOL by 50% or more in RA patients.