Introduction
Systemic lupus erythematosus
Pain in SLE
Participants and methods
Study population
Disease activity and damage
Self-assessment questionnaires
Statistics
Ethics
Results
All patients, n = 64 | Patients with low pain, n = 50 (78%) | Patients with decreased pain, n = 7 (11%) | Patients with remaining pain, n = 7 (11%) | Controls, n = 68 | ||||||||||||
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Overall pain, VAS, mmb | 17 (3 to 45) | 23 (6 to 45) | 0.98 | 13 (3 to 23) | 18 (4 to 35) | 0.21 | 67 (51 to 71) | 14 (10 to 44) | 0.031* | 78 (46 to 96) | 64 (52 to 75) | 0.92 | 5 (0 to 29) | 11 (2 to 30) | 0.09 | |
Changec in overall pain, mmb | – | 0 (− 12 to 15) | – | – | − 1 (− 12 to 6) | – | – | 48 (31 to 61) | – | – | − 0.5 (− 18 to 35) | – | – | − 2(− 13 to 14) | – | |
SLE-related pain, VAS, mmb | 11 (2 to 31) | 11 (1 to 33) | 0.92 | 7 (1 to 16) | 8 (1 to 22) | 0.19 | 70 (60 to 72) | 15 (2 to 37) | 0.021* | 67 (47 to 83) | 66 (55 to 73) | 0.87 | – | – | – | |
Changec in SLE-related pain, mmb | – | 1 (− 7 to 7) | – | – | 0 (− 6 to 2) | – | – | 45 (35 to 65) | – | – | − 13(− 20 to 28) | – | – | – | – | |
Problem SLE-related pain, VAS, mmb | – | 12 (2 to 32) | – | – | 6 (1 to 23) | – | – | 15 (3 to 29) | – | – | 54 (47 to 88) | – | – | – | – | |
Remaining pain > 3 monthsd | – | 36 (56) | – | – | 25 (50) | – | – | 4 (57) | – | – | 7 (100) | – | – | 34 (50) | – | |
Chronic widespread pain/ACR90 [31]d | – | 20 (31) | – | – | 13 (26) | – | – | 0 (0) | – | – | 7 (100) | – | – | 9 (13) | – | |
Number of body regions with pain > three monthsb | – | 7 (4 to 11) | – | – | 6 (4 to 9) | – | – | 4 (3 to 4) | – | – | 11 (9 to 15) | – | – | 3 (2 to 4) | – | |
Use of analgesics, regulard | – | – | – | – | 12 (24) | – | – | 1 (14) | – | – | 6 (86) | – | – | 6 (7) | – | |
Use of analgesics, as neededd | – | – | – | – | 18 (36) | – | – | 4 (57) | – | – | 1 (14) | – | – | 41 (48) | – | |
No use of analgesicsd | – | – | – | – | 20 (40) | – | – | 2 (29) | – | – | 0 (0) | – | – | 39 (45) | – |
Characteristics of the patients as grouped by pain and the controls
Low pain, n = 50 | Decreased pain, n = 7 | Remaining pain, n = 7 | Controls, n = 68 | |||||||||
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Year 0 | Year 7 |
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Age, yearsb | 45 (32 to 57) | 53 (38 to 64) | – | 41 (36 to 52) | 48 (43 to 59) | – | 48 (30 to 60) | 55 (38 to 67) | – | 49 (39 to 59) | 56 (47 to 66) | – |
Sex, female/men, n | 42/8 | 42/8 | – | 6/1 | 6/1 | – | 7/0 | 7/0 | – | 58/10 | 58/10 | – |
SLAMb | 5 (4 to 8) | 4 (2 to 7) | 0.007* | 12 (7 to 19) | 5 (3 to 6) | 0.018* | 9 (5 to 14) | 8 (6 to 11) | 0.40 | – | – | – |
Changec in SLAMb | – | 1 (− 1 to 3) | – | – | 9 (1 to 14) | – | – | 1 (− 3 to 6) | – | – | – | – |
Physicians’ reported disease activity. VAS/SLAM, mmb | – | 5 (0 to 12) | – | – | 5 (2 to 10) | – | – | 15 (9 to 17) | – | – | – | – |
Patients’ reported disease activity. VAS/SLAM, mmb | 12 (8 to 22) | 12 (2 to 22) | 0.19 | 62 (49 to 70) | 6 (3 to 34) | 0.043* | 50 (44 to 81) | 50 (49 to 73) | 0.69 | – | – | – |
Changec in patient´ VAS/SLAM, mmb | – | 5 (− 6 to 13) | – | – | 56 (4 to 64) | 0 (− 17 to 27) | – | – | – | – | ||
Difference between patients’ and physicians’ global disease activity, VAS/SLAM, mmb | – | 6 (1 to 13) | – | – | 4 (1 to 24) | – | – | 35 (33 to 46) | – | – | – | – |
SLEDAIb | 1 (0 to 4) | 1 (0 to 4) | 0.28 | 7 (3 to 16) | 0 (0 to 2) | 0.046* | 2 (0 to 4) | 0 (0 to 2) | 0.36 | – | – | – |
Changec in SLEDAI | – | 0 (0 to 2) | – | – | 7 (0 to 16) | – | – | 0 (0 to 4) | – | – | – | – |
SLICCb | 0 (0 to 1) | 2 (0 to 3) | < 0.001* | 1 (0 to 4) | 2 (1 to 4) | 0.11 | 0 (0 to 2) | 1 (0 to 3) | 0.043* | – | – | – |
Changec in SLICCb | – | − 1 (− 2 to − 0) | – | – | 0 (− 1 to 0) | – | – | − 1 (− 1 to 0) | – | – | – | – |
Disease duration, yearsb | 10 (5 to 17) | 17 (12 to 24) | – | 4 (1 to 11) | 11 (8 to 18) | – | 6 (3 to 10) | 13 (10 to 18) | – | – | – | – |
Treatment with glucocorticoidsd | 32 (64) | 27 (54) | – | 5 (71) | 4 (57) | – | 5 (71) | 3 (43) | – | – | – | – |
Current dose gluco-corticoid, po, mgb | 3.4 (0 to 5) | 2.5 (0 to 5) | 0.75 | 7.5 (0 to 17.5) | 2.5 (0 to 5) | 0.09 | 5 (0 to 12.5) | 0 (0 to 5) | 0.22 | – | – | – |
Changed in current dose gluco-corticoid, po, mgb | – | 0 (− 1.3 to 2.5) | – | – | 5 (0 to 12.5) | – | – | 0 (− 2.5 to 10) | – | – | – | – |
Current treatment with DMARDd | 45 (90) | 38 (76) | – | 6 (86) | 4 (57) | – | 7 (100) | 6 (86) | – | – | – | – |