Chronic pain and inflammation are common features of rheumatic conditions such as Psoriatic Arthritis (PsA) and Axial Spondyloarthritis (axSpA), often needing prolonged medication treatment for effective management. Maintaining drug retention is essential for both achieving disease control and improving patients' quality of life. This study investigates the influence of pain catastrophizing, a psychological response to pain, on the drug retention rates of PsA and axSpA patients. A two-year prospective multicenter observational study involved 135 PsA and 71 axSpA patients. Pain Catastrophizing Scale (PCS) was employed to assess pain catastrophizing. Univariable and multivariable regression analyses were utilized to identify factors associated with drug retention. In the PsA group, patients early discontinuing therapy showed higher baseline disease activity as well as higher incidence of comorbid fibromyalgia. Notably, pain catastrophizing, specifically the domains of Helplessness, Magnification, and Rumination, were significantly elevated in PsA patients who interrupted the treatment. Multivariable analysis confirmed pain catastrophizing as an independent predictor of drug suspension within two years. In axSpA, drug discontinuation was associated with female gender, shorter disease duration, higher baseline disease activity as well as elevated levels of pain catastrophizing. Univariable analysis supported the role of pain catastrophizing, including its domains, as predictors of treatment interruption. However, limited events in axSpA patients precluded a multivariate analysis. This prospective study emphasizes the impact of pain catastrophizing on drug retention in patients with PsA and axSpA.

中文翻译：

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疼痛灾难化对银屑病关节炎和中轴型脊柱关节炎患者的药物保留率产生负面影响：来自 2 年多中心 GIRRCS（Gruppo Italiano di Ricerca in Reumatologia Clinica）研究的结果


慢性疼痛和炎症是银屑病关节炎 (PsA) 和中轴型脊柱关节炎 (axSpA) 等风湿性疾病的常见特征，通常需要长期药物治疗才能有效治疗。保持药物保留对于实现疾病控制和改善患者的生活质量至关重要。本研究调查了疼痛灾难化（对疼痛的心理反应）对 PsA 和 axSpA 患者药物保留率的影响。一项为期两年的前瞻性多中心观察研究涉及 135 名 PsA 和 71 名 axSpA 患者。采用疼痛灾难化量表（PCS）来评估疼痛灾难化。利用单变量和多变量回归分析来确定与药物保留相关的因素。在 PsA 组中，早期停止治疗的患者表现出较高的基线疾病活动度以及较高的共病纤维肌痛发生率。值得注意的是，中断治疗的银屑病关节炎患者的疼痛灾难化程度，特别是无助、放大和沉思的程度显着升高。多变量分析证实疼痛灾难性是两年内药物暂停的独立预测因素。在 axSpA 中，停药与女性、病程较短、基线疾病活动度较高以及疼痛灾难性程度升高有关。单变量分析支持疼痛灾难化（包括其领域）作为治疗中断的预测因素的作用。然而，axSpA 患者的有限事件排除了多变量分析。这项前瞻性研究强调了疼痛灾难性对 PsA 和 axSpA 患者药物保留的影响。