期刊
CURRENT OSTEOPOROSIS REPORTS
卷 16, 期 5, 页码 603-610出版社
SPRINGER
DOI: 10.1007/s11914-018-0473-5
关键词
Pain; Rheumatoid arthritis; Disease activity; Inflammation
资金
- NIAMS NIH HHS [P30 AR072579, R01 AR064850] Funding Source: Medline
Purpose of ReviewPain in rheumatoid arthritis (RA) may be due to different etiologies, ranging from peripheral inflammation to dysregulation of central nervous system (CNS) processing. This review evaluates relevant literature published on RA pain mechanisms in recent years.Recent FindingsDespite successes of disease-modifying antirheumatic drugs (DMARDs), pain persists for many RA patients. Studies involving patient-reported outcomes, quantitative sensory testing, and neuroimaging indicate that, in addition to joint inflammation, abnormalities in CNS pain processing may contribute to pain. Some DMARDs (e.g., janus kinus inhibitors) may work via multiple pathways to decrease pain. Adjunctive treatments (e.g., antidepressants, antiepileptics) may also be useful in managing pain in RA patients with well-controlled disease.SummaryBoth peripheral and central mechanisms play key roles in the expression of pain in RA. To effectively manage pain, physicians need accurate assessment tools to identify the pathways involved in each patient so that treatments may be appropriately targeted.
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