scholarly journals Comparison of 3 Approaches to Percutaneous Epidural Adhesiolysis and Neuroplasty in Post Lumbar Surgery Syndrome

2018 ◽  
Vol 1 (21;1) ◽  
pp. E501-E508
Author(s):  
Haitham Hamdy Salem
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Group Analysis ◽  
Pain Severity ◽  
University Hospital ◽  
Pain Clinic ◽  
Complication Rates ◽  
Lumbar Surgery ◽  
Time Intervals ◽  
Number Of Patients

Background: Percutaneous epidural adhesiolysis and neuroplasty (PEAN) has been proven to be safe and effective in treating different spine pathologies, in particular post lumbar surgery syndrome (PLSS). Objectives: The purpose of this study was to compare the efficacy and complication rates of the 3 different PEAN anatomical approaches (caudal, S1 foraminal, and L5-S1 transforaminal) used to treat PLSS. Study Design: This study used a case control, blind study. Setting: The research took place at the pain clinic and interventional pain practice room at Asyut University Hospital, Assiut, Egypt. Methods: Sixty consecutive PLSS patients were recruited and randomized into 3 groups (caudal, S1 foraminal, and L5-S1 transforaminal) before receiving adhesiolysis and neuroplasty. All patients underwent nerve conduction studies and magnetic resonance imaging (MRI). Pain severity levels were assessed and measured using the Oswestry Disability Questionnaire (OSW) and the Visual Analog Scale (VAS). Patient satisfaction was evaluated using a Likert scale. The first assessment was performed prior to the procedure to determine the patients’ baseline levels of pain severity. Followup assessments were performed 1-, 3-, and 6-months after the procedure. Results: Results of the group pairwise analysis indicated that, relative to baseline, there were significant decreases in pain relief scores (VAS and OWS) and functional assessment expressed by patients’ satisfaction across all time intervals and in all 3 groups (P < 0.01). Conversely, a between group analysis revealed that VAS, OWS, and patient satisfaction scores were comparable across the 3 groups at all time intervals (P > 0.05). There were no differences in rates of complications between the 3 different groups. Limitations: Our study was limited by the low number of patients and the short duration (6 months) of follow-up. Conclusion: The 3 anatomical approaches (caudal, S1 foraminal, and L5-S1 transforaminal) result in the same outcome with regard to pain relief and complication rate. Key words: Post lumber surgery syndrome, post laminectomy back pain, percutaneous adhesiolysis, Racz catheter, percutaneous neuroplasty

scholarly journals A Staged Treatment of Symptomatic Lumbar Intraspinal Synovial Cysts

2019 ◽  
Vol 5 (22;5) ◽  
pp. E451-E456
Author(s):  
Kyung-Hoon Kim
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedures ◽  
Facet Joint ◽  
University Hospital ◽  
Pain Clinic ◽  
Level Of Evidence ◽  
Endoscopic Surgical Procedures ◽  
Number Of Patients ◽  
Synovial Cysts

Background: Lumbar intraspinal synovial cyst (LISC) refers to a cyst that arises from the zygapophyseal joint capsule of the lumbar spine and contains serous or gelatinous fluid. In cases of LISCs resistant to conservative treatments, various minimally invasive percutaneous spinal techniques (MIPSTs) may be applied prior to open surgery. Objectives: The outcomes of 3-staged MIPSTs for the treatment of symptomatic LISCs resistant to conservative treatments were evaluated. Study Design: An institutional review board approved retrospective chart review. Setting: University hospital inpatients referred to our pain clinic. Methods: Review of charts of all patients who underwent MIPSTs for symptomatic LISCs resistant to conservative treatments during a time period of 13 years at a university hospital pain clinic. Patients with symptomatic LISCs resistant to conservative treatments were treated with 3-staged MIPSTs, including image-guided intraarticular aspiration, cyst distention and rupture, and injection of corticosteroids (ARI), endoscopic cyst enucleation (ECE), and endoscopic superior facetectomy (ESF) by a single pain specialist. A symptom-free period after each intervention was evaluated. Recurrence was defined as the same recurrent symptomatic radicular pain with confirmation of the LISC on magnetic resonance imaging. All patients with a minimum follow-up time of 3 years were included. Results: Of the 40 patients who underwent ARI, 3 patients failed to complete a follow-up and 19 patients (51.4%) who had recurring symptoms received ECE. Ten patients (52.6%) who had rerecurring symptoms after ECE received ESF. There was no recurrence after ESF. Limitations: This retrospective and observational study with a limited number of patients does not represent a high level of evidence. Conclusions: This information provided the recurrence rate after each intervention. Half of the patients who went on to receive ARI experienced recurrence, whereas half of the patients with recurrence who received ECE experienced re-recurrence. ESF treatment resulted in no recurrence within the 3-year study period. Key words: Conservative treatment, endoscopic surgical procedures, facet joint, intraarticular injection, minimally invasive surgical procedures, needle biopsy, nerve root compression, radiculopathy, synovial cysts

scholarly journals Effects of Pulsed Versus Conventional Versus Combined Radiofrequency for the Treatment of Trigeminal Neuralgia: A Prospective Study

2017 ◽  
Vol 6 (20;6) ◽  
pp. E873-E881
Author(s):  
Ghaydaa A. Ghaydaa A.
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Prospective Study ◽  
University Hospital ◽  
Gasserian Ganglion ◽  
Pulsed Radiofrequency ◽  
Group Setting ◽  
Idiopathic Trigeminal Neuralgia ◽  
Number Of Patients ◽  
A Prospective Study

Background: During radiofrequency bursts of energy are applied to nervous tissue. The clinical advantages of this treatment remain unclear. Objectives: We compared the effectiveness and pain relief for idiopathic trigeminal neuralgia (TN) after continuous radiofrequency (CRF), pulsed radiofrequency (PRF), and combined continuous and pulsed radiofrequency (CCPRF) treatment of the Gasserian ganglion (GG). Study Design: We conducted a randomized prospective study. Forty-three patients were included. Eleven patients were treated with PRF at 42°C for 10 minutes (PRF group), 12 patients received CRF for 270 seconds at 75 °C (CRF group), and 20 patients received PRF for 10 minutes at 42°C followed by CRF for at 60°C for 270 seconds (CCPRF group). Setting: Assuit University Hospital, Pain and Neurology outpatient clinics. Methods: Patients were assessed for pain, satisfaction, and consumption of analgesics at baseline and 7 days, one month, 6 months, 12 months, and 24 months after the procedure. The incidence of complications, anesthesia dolorosa, weakness of muscles of mastication, numbness, and technical complications, was evaluated after the procedure. Results: Excellent pain relief was achieved after 6, 12, and 24 months, respectively in 95%, 85%, and 70% of patients with CCPRF; 75%, 75%, and reduced to 50% among patients with CRF; and 82%, reduced to 9.1%, and 0% of patients with PRF. No complications were recorded in 75% of patients in the CCPRF and PRF groups. There was one case of anesthesia dolorosa, 4 cases of masseter muscle weakness, and 5 cases of severe numbness recorded in the CRF group. Limitation: There was a small number of patients in each group. Conclusion: The best results were observed in the CCPRF group, followed by the CRF group, and then the PRF group.

Computed Tomography-Guided Radiofrequency Thermocoagulation of the Gasserian Ganglion Using an Alternative to Hartel Anterior Approach: A Bicentral Study

2020 ◽  
Vol 3;23 (6;3) ◽  
pp. 293-298 ◽  
Author(s):  
Dimitrios K. Filippiadis
Keyword(s):  
Computed Tomography ◽  
Pain Relief ◽  
Anterior Approach ◽  
Anatomic Variation ◽  
Control Group ◽  
Complication Rates ◽  
Gasserian Ganglion ◽  
Ct Guided ◽  
Radiofrequency Thermocoagulation ◽  
Number Of Patients

Background: Trigeminal neuralgia (TN) is associated with multiple mechanisms involving peripheral and central nervous system pathologies. Among percutaneous treatments offered, radiofrequency thermocoagulation (RFT) is associated with longer duration of pain relief. Mostly due to anatomic variation, cannulation of the foramen ovale using the Hartel approach has a failure rate of 5.17%. Objectives: To report safety and efficacy of continuous RFT with an alternative to Hartel anterior approach under computed tomography (CT) guidance in patients with classic TN. Study Design: Retrospective institutional database review; bicentral study. Setting: Although this was a retrospective database research, institutional review board approval was obtained. Methods: Institutional database review identified 10 patients (men 8, women 2) who underwent CT-guided RFT of the Gasserian ganglion. Preoperational evaluation included physical examination and magnetic resonance imaging. Under anesthesiology control and local sterility measures, a radiofrequency needle was advanced, and its approach was evaluated with sequential CT scans. Motor and sensory electrostimulation tests evaluated correct electrode location. Pain prior, 1 week, 1, 3, and 6 months after were compared by means of a numeric visual scale (NVS) questionnaire. Results: Mean self-reported pain NVS score prior to RFT was 9.2 ± 0.919 units. One week after the RFT mean NVS score was 1.10 ± 1.287 units (pain reduction mean value of 8.1 units). At 3 and 6 months after thermocoagulation the mean NVS score was 2.80 ± 1.549 units and 2.90 ± 1.370 units, respectively. There were no postoperative complications. Three patients experienced facial numbness, which gradually resolved over a period of 1 month. Limitations: Retrospective nature; small number of patients; lack of a control group undergoing a different treatment of TN. Conclusions: Percutaneous CT-guided RFT of the Gasserian ganglion constitutes a safe and efficacious technique for the treatment of TN, with significant pain relief and minimal complication rates improving life quality in this group of patients. Key words: Trigeminal nerve, neuralgia, pain, radiofrequency, ablation, percutaneous, computed tomography, imaging

scholarly journals A COMPARISON OF INTRAVENOUS ONDANSETRON AND PALONOSETRON IN PREVENTING POST-OPERATIVE NAUSEA AND VOMITING AFTER LAPAROSCOPIC CHOLECYSTECTOMY - A RANDOMIZED DOUBLE-BLIND STUDY

2018 ◽  
Vol 11 (12) ◽  
pp. 128
Author(s):  
Ajay Kumar ◽  
Sumita Adhana ◽  
Puneet Dwivedi
Keyword(s):  
Patient Satisfaction ◽  
Laparoscopic Cholecystectomy ◽  
Side Effect ◽  
Nausea And Vomiting ◽  
Side Effect Profile ◽  
Time Intervals ◽  
Patient Satisfaction Scores ◽  
Number Of Patients ◽  
Post Operative Nausea ◽  
Rescue Antiemetic

Objectives: Post-operative nausea and vomiting (PONV) is a frequently experienced complication following laparoscopic cholecystectomy. This study was planned to compare the antiemetic efficacy of palonosetron with ondansetron in patients undergoing laparoscopic cholecystectomy.Methods: A total of 100 patients undergoing laparoscopic cholecystectomy were randomized into two groups. Group O (n=50) received ondansetron (8 mg) and Group P (n=50) received palonosetron (0.075 mg) 3 min before induction of anesthesia. Post-operatively, patients were assessed for the occurrence of nausea, retching, or vomiting at 0–2, 2–6, 6–24, 0–24, and 24–48 h time intervals. The overall incidence of PONV in time frame (0–48 h) was determined. The need of rescue antiemetic, side effect profile, and patient satisfaction scores were also assessed.Results: The incidence and severity of nausea at all the time intervals were comparable in the two groups. The incidence of vomiting was significantly less in Group P as compared to Group O in 0–2 h (2% vs. 14%, p=0.027) and 0–24 h time intervals (10% vs. 30%, p=0.012). The overall incidence of PONV in 0–48h was lesser in Group P as compared to Group O (28% vs. 50%, p=0.024). Rescue antiemetic was required in greater number of patients in Group O as compared to Group P (p=0.038). Side effect profile and patient satisfaction scores were comparable in the two groups.Conclusion: Palonosetron is better than ondansetron in lowering the overall incidence of PONV in 0–48 h time interval, in patients undergoing laparoscopic cholecystectomy.

scholarly journals Quality Assurance for Interventional Pain Management Procedures in Private Practice

2008 ◽  
Vol 1;11 (1;1) ◽  
pp. 43-55
Author(s):  
YiLi Zhou
Keyword(s):  
Quality Assurance ◽  
Patient Satisfaction ◽  
Pain Management ◽  
Pain Relief ◽  
Private Practice ◽  
Complication Rates ◽  
Large Joint ◽  
Management Procedures ◽  
Interventional Pain Management

Background: A recent study has indicated that quality assurance for interventional pain management procedures (IPMPs) can be achieved in university pain clinics. However, the issue of quality assurance for IPMPs in private practice has not yet been addressed. Objective: This study was designed to monitor the quality of IPMPs in a private pain practice in north Florida. Methods: From November 2005 to July 2006, we monitored the quality of IPMPs in a private pain practice in north Florida. Questionnaires regarding degree of pain relief, patient satisfaction, and complications were handed to patients immediately after the completion of each IPMP. Follow-up phone calls were also made to patients 1 day after the IPMPs. Results: A total of 771 (male: 249, female: 522) patients with a mean age of 58.1 years participated in the study. Office-based IPMPs included lumbar and cervical epidural steroid injections, lumbar and cervical facet joint blocks, selective nerve root blocks, lumbar and cervical sympathetic nerve blocks, sacroiliac joint injection, and large joint injections. Seven-hundred patients (90.8%) reported various degrees of pain relief immediately following IPMPs. Average pain score decreased by 4.3 on a 0 to 10 scale (p=<0.001). Number needed to be treated (NNT) to reach 50% or more pain relief immediately after IPMPs was 1.4. Six-hundred ninety-two (89.7%) patients were satisfied or very satisfied with the results of IPMPs. sixty-two patients (8%) developed headaches after IPMPs, which lasted from 30 minutes to 4 days. None of these patients required a blood patch. Five patients developed moderate vasovagal responses during IPMPs, in which their heart rates decreased to <45/min, BP <90/60mmHg. The IPMPs were aborted immediately. All of these patients recovered uneventfully within a few minutes. No other serious adverse events were reported. Conclusions: The results of the current study suggest that high quality private interventional pain programs with high efficacy, high patient satisfaction, and low complication rates can be achieved through appropriate staff training, proper monitoring of patients during IPMPs, and adequate handling of patients after the IPMPs. Key words: Interventional pain management procedures, quality assurance, efficacy, patient satisfaction

scholarly journals Methylprednisolone Dosage in Lumbar Epidural Steroid Injections: A Retrospective Analysis of Efficacy in Pain Relief

2020 ◽  
pp. 25-32
Author(s):  
Calvin Rong Chen
Keyword(s):  
Pain Relief ◽  
Adverse Effects ◽  
Retrospective Chart Review ◽  
Similar Efficacy ◽  
Pain Scale ◽  
Pain Clinic ◽  
Steroid Injections ◽  
Epidural Steroid Injections ◽  
Number Of Patients ◽  
Epidural Steroid

Background: Epidural injections have been used for pain relief since the 1880s. Corticosteroids are antiinflammatory medications that can alleviate pain, but also have harmful systemic adverse effects. Literature regarding methylprednisolone dosage efficacy is limited. Objectives: To determine the lowest effective dose of methylprednisolone in a lumbar epidural steroid injection (LESI) for maximal pain relief without exposing patients to adverse events caused by steroid use. Study Design: Retrospective chart review. Setting: Outpatient interventional pain clinic at an academic center. Methods: Adults (n = 133), aged 18 to 85 years, with low-back pain and radicular symptoms treated with LESI from August 2011 to November 2015. Patients who received prior cervical epidural steroid injections were excluded. Interventions were LESI with methylprednisolone 40 mg, 80 mg, or 120 mg. Main outcome measures showed change in pain score using a numeric pain scale (NPS; 0 = no pain, 10 = excruciating pain), and patient’s self-reported reduction in pain (percentage), pre- and postprocedure. The primary endpoint measurement was 2 weeks postinjection. Adverse effects were recorded. Results: The number of patients who received each dose varied: n = 88 received 120 mg, n = 30 received 80 mg, and n = 13 received 40 mg. The NPS pain scores pre- and postprocedure for 120 mg were 8.89 ± 1.32 and 4.08 ± 3.74, (mean ± standard deviation), respectively; for 80 mg: 9.06 ± 1.00 and 3.75 ± 4.00; and for 40 mg: 9.00 ± 1.00 and 4.00 ± 0.00. Percentage of pain relief for 120 mg, 80 mg, and 40 mg was 57.26%, 50.74%, and 57.26, respectively (P = 0.3347). n = 4 experienced adverse effects, all received 120 mg. Conclusions: All 3 dosage groups had similar efficacy in pain relief, but only patients who received 120 mg experienced adverse effects. This demonstrates that lower dosages can be used for pain relief with less potential harm to the patient. Key words: Methylprednisolone, interlaminar epidural, radiculopathy

Transcutaneous Peripheral Nerve Stimulation for the Treatment of Neuropathic Pain in the Upper Limb

2016 ◽  
Vol 21 (01) ◽  
pp. 37-43 ◽  
Author(s):  
A. Sierakowski ◽  
S.S. Jing ◽  
J. Poel ◽  
D. Elliot
Keyword(s):  
Neuropathic Pain ◽  
Pain Relief ◽  
Peripheral Nerve ◽  
Upper Limb ◽  
Nerve Stimulation ◽  
Peripheral Nerve Stimulation ◽  
Pain Severity ◽  
Intractable Pain ◽  
Paired Data ◽  
Number Of Patients

Background: A small number of patients develop intractable peripheral nerve pain following injury or surgery to the upper limb that is refractory to pharmacological treatment. This study reports our results of using transcutaneous peripheral nerve stimulation (TPNS), a non-invasive form of neuromodulation, to treat this difficult problem. Methods: Seventy-two patients were treated for intractable pain in the upper limb using this technique. Electrical current was delivered transcutaneously through a handheld probe, placed on the skin overlying the affected peripheral nerve proximal to the site of pain. Pain severity was determined before and immediately after treatment by subjective patient self-assessment using a visual analogue pain scale. Pre-post treatment changes in pain severity were analysed by Student's test for paired data. Outcome in respect of overall effectiveness of this treatment, was graded according to the maximum duration of pain relief achieved. Results: Overall, TPNS reduced pain intensity from 8.4 (SD 1.6) before treatment to 4.2 (SD 3.5) immediately after treatment, a highly significant effect ([Formula: see text]). The treatment achieved cure in 8/72 (11%) of our patients and a useful therapeutic outcome (pain relief ≥ 1 day) in 27/72 (38%). The treatment failed in 37/72 (51%). Conclusions: TPNS warrants consideration as a therapy for neuropathic pain in the upper limb after drug treatment has failed and before offering surgery or spinal root stimulation.

scholarly journals Nursing Communication as a Tool for Patient Satisfaction. A Single Hospital Survey

2019 ◽  
Vol 13 (1) ◽  
pp. 220-227
Author(s):  
Anna Barilaro ◽  
Arianna Conidi ◽  
Sabrina Ligarò ◽  
Francesca Licata ◽  
Maria Anna Marinaro ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Patient Satisfaction ◽  
Hospital Stay ◽  
Multiple Logistic Regression Analysis ◽  
New Drugs ◽  
University Hospital ◽  
Surgical Department ◽  
Number Of Patients ◽  
Nursing Communication ◽  
Nursing Skills

Background: Communication is an essential tool for health promotion. Effective healthcare communication has great therapeutic value. Objective: The aim of the study is to assess the degree of patient satisfaction related to nursing communication in the various stages of hospital stay. Methods: Patients admitted to General University Hospital in medical and surgical department were subjected to this survey using a questionnaire, structured in four sections (acceptance, hospital stay, discharge, pain and new drugs management). Chi-square and multivariate logistic regression models were used to test the association between the outcome of interest defined as the satisfaction of nursing communication and the independent variables. Results: One thousand three hundred seventy questionnaires were administered. In acceptance, among patients satisfied with nursing skills related to explaining the department's functioning, most were satisfied with nursing communication (972 vs 87 p <0.005). Also during the hospital stay, among patients satisfied with nursing Skills and Manner relating to communication most were significantly satisfied with the nursing communication (849 vs 74 p <0.005 and 987 vs 55 p <0.001). At the discharge, the number of patients satisfied with nursing communication was greater among patients who considered the length of hospital stay adequate (1020 vs 65 p <0.001). Data are confirmed by the multiple logistic regression analysis. Conclusion: Our study shows how nursing communication is the key to establishing a good therapeutic care relationship and how it can be associated with patient satisfaction in various phases of hospital stay.

scholarly journals Is Standardization Transferable? Initial Experience of Urethral Surgery at the University Hospital Frankfurt

2020 ◽  
Vol 7 ◽  
Author(s):  
Mike Wenzel ◽  
Marieke J. Krimphove ◽  
Benedikt Lauer ◽  
Benedikt Hoeh ◽  
Matthias J. Müller ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Urethral Stricture ◽  
Final Analysis ◽  
University Hospital ◽  
Successful Implementation ◽  
Complication Rates ◽  
Surgery Patient ◽  
Patient Reported ◽  
The University ◽  
Urethral Surgery

Background: Since January 2018 performance of urethroplasties is done on regular basis at the University Hospital Frankfurt (UKF). We aimed to implement and transfer an institutional standardized perioperative algorithm for urethral surgery (established at the University Hospital Hamburg-Eppendorf—UKE) using a validated Urethral Stricture Surgery Patient-Reported Outcome Measure (USS-PROM) in patients undergoing urethroplasty at UKF.Materials and Methods: We retrospectively analyzed all patients who underwent urethroplasty for urethral stricture disease between January 2018 and January 2020 at UKF. All patients were offered to revisit for clinical follow-up (FU) and completion of USS-PROM. Primary end point was stricture recurrence-free survival (RFS). Secondary endpoints were functional outcomes, quality of life (QoL), and patient satisfaction.Results: In total, 50 patients underwent urethroplasty and 74 and 24% had a history of previous urethrotomy or urethroplasty, respectively. A buccal mucosal graft urethroplasty was performed in 86% (n = 43). After patient's exclusion due to lost of FU, FU &lt;3 months, and/or a pending second stage procedure, 40 patients were eligible for final analysis. At median FU of 10 months (interquartile-range 5.0–18.0), RFS was 83%. After successful voiding trial, the postoperative median Qmax significantly improved (24.0 vs. 7.0 mL/s; p &lt; 0.01). Conversely, median residual urine decreased significantly (78 vs. 10 mL; p &lt; 0.01). Overall, 95% of patients stated that QoL improved and 90% were satisfied by the surgical outcome.Conclusions: We demonstrated a successful implementation and transfer of an institutional standardized perioperative algorithm for urethral surgery from one location (UKE) to another (UKF). In our short-term FU, urethroplasty showed excellent RFS, low complication rates, good functional results, improvement of QoL and high patient satisfaction. PROMs allow an objective comparison between different centers.

scholarly journals AB0135 A VERY EARLY CLINICAL RESPONSE TO TOFACITINIB IS ASSOCIATED WITH LOW RHEUMATOID ARTHRITIS ACTIVITY AFTER 3 AND 6 MONTHS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1095.3-1096
Author(s):  
A. Karateev ◽  
A. Lila ◽  
E. Nasonov ◽  
V. Mazurov ◽  
D. Chakieva ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Response ◽  
Central Sensitization ◽  
Intracellular Signaling ◽  
Pain Reduction ◽  
Pain Severity ◽  
Jak Inhibitors ◽  
Significant Pain ◽  
Number Of Patients ◽  
Days Of Therapy

Background:JAK inhibitors block intracellular signaling pathways responsible for the synthesis of cytokines and mediators involved in the development of chronic pain and central sensitization (CS). This determines a very rapid clinical response to JAK inhibitors. However, it is not clear how the significant pain reduction in the first weeks of therapy is associated with the achievement of low rheumatoid arthritis (RA) activity.Objectives:to assess the relationship between the early clinical response to tofacitinib and the decrease in RA activity after 3 and 6 months.Methods:Study group included 88 patients with RA, their age was 53±11,5, 79.3% of women, 89.8% of RF “+”, DAS28 5.2±1.2, receiving DMARDs (methotrexate 59.5% and leflunomide 19.8%), who were administered with tofacitinib 5 mg 2 times a day due to inefficacy or intolerance of biological DMARDs. There were assessed the pain severity using Brief pain inventory (BPI) questionnaire, the presence of neuropathic pain component (NPC) using PainDETECT questionnaire and signs of CS using Central Sensitisation Inventory (CSI) questionnaire at early time after tofacitinib administration, RA activity using DAS28 after 3 and 6 months.Results:The mean pain severity at baseline was 5.3±2.0 according to the visual analogue scale (VAS 0-10), 51.1% of patients had signs of central sensitization (CSI ≥ 40), 15.9% had NPC (PainDETECT ≥18). 7 days after tofacitinib intake there was statistically reliable reduction of pain severity – up to 4.1±1.8 (р<0.05) and CS – CSI from 40.4±13.5 to 36.5±12.5 (р=0.01). After 28 days, the effect was higher: the pain level (VAS) was 2.8±1.6 (p=0.000), PainDETECT decreased from 11.8±5.6 to 6.8±3.1 (p=0.000), CSI – to 31.6±13.9 (p=0.000). DAS28 after 3 and 6 months was 3.7±1.3 and 3.6±1.2. The number of patients with pain decrease of ≥50% after 28 days of therapy was 59.9%. Low RA activity after 3 months. (DAS28 ≤3.2) was achieved in 64.4% of patients. There was a clear correlation between the number of patients with significant pain reduction at 28 days and the number of patients with low RA activity after 3 and 6 months (rS=0.548, p=0.000; rS=0.790, p=0.000). Six patients withdrew from the study due to inefficacy or social reasons. There were no serious adverse reactions.Conclusion:The application of JAK inhibitor tofacitinib allows to reach a fast analgesic effect and reduce CS signs. An early clinical response to tofacitinib (pain relief) predicts a decrease in RA activity after 3 and 6 months of the therapy.Limitation: Open-label observatory study.Disclosure of Interests:None declared

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