E.YU. AKULINUSHKINA¹, S.P. YAKUPOVA^2,3, E.Z. YAKUPOV⁴, N.I. MAKSIMOV⁵

 ¹Republic Clinical Diagnostic Center, Izhevsk

²Kazan State Medical University, Kazan

³Republic Clinical Hospital, Kazan

⁴Vashe zdorovye Research Facility, Kazan

⁵Izhevsk State Medical Academy, Izhevsk

 Contact details:

Akulinushkina E.Yu. – rheumatologist

Address: 87B Lenin St., Izhevsk, Russian Federation, 426000, tel.: +7-999-228-37-92, e-mail: katewenterly@gmail.com

 Abbreviations: АксПсА — axial psoriatic arthritis; ВАШ — visual analogous scale; КЖ — quality of life; МРТ — magnetic-resonance tomography; НЦБ — nociplastic pain; ОЗП — patient’s assessment of the disease activity; ПсА — psoriatic arthritis; пПсА — peripheral psoriatic arthritis; СРБ — С-reactive protein; СИ — sacroiliitis; ЧБС — number of tender joints; ЧПС — number of swollen joints; ASAS-HI — Assessment of Spondyloarthritis International Society Health Index; ASDAS — Ankylosing Spondylitis Disease Activity Score; BASDAI — The Bath Ankylosing Spondylitis Disease Activity Index; DAPSA — Disease activity in psoriatic arthritis; PsAID-12 — Psoriatic Arthritis Impact of Disease 12-item questionnaire

 The purpose — to determine clinical and laboratory features of axial psoriatic arthritis (AxPsA); to study the impact of nociplastic pain (NP) on the clinical features and quality of life (QoL) in patients with AxPsA.

Material and methods. 127 adult patients with psoriatic arthritis (PsA) were included. The number of tender (TJ) and swollen joints (SJ), patient global assessment and severity of pain, C-reactive protein (CRP) were determined. Activity of PsA was assessed with DAPSA, ASDAS, and BASDAI. NP was determined by screening using the CSI and neurologist’s examination. Sacroiliitis (SI) was determined with MRI. QoL was assessed with PsAID-12 and ASAS-HI.

Results. SI was found in 60 (47.2%) patients with PsA (AxPsA). The TJ, SJ, CRP, DAPSA, ASDAS were found in higher values and values of CRP above normal, erosive peripheral arthritis and enthesitis were more often found in patients with AxPsA. NP was found in 30 (50%) patients with AxPsA who showed worse pain scores, BASDAI, ASDAS, and QoL. The indicators of TJ, SJ, and CRP in the groups did not differ.

Conclusion. SI in PsA is associated with more severe peripheral and laboratory manifestations, but not with more severe pain. Patients with AxPsA with NP have higher rates of disease activity which are associated with degradation of patient reported outcomes including QoL without degradation of inflammation signs. For improving the QoL of patients with PsA it is necessary to study the mechanisms of chronic pain.

Key words: nociplastic pain, chronic pain, axial psoriatic arthritis, sacroiliitis, quality of life.

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