Changes in Descending Pain Modulation During Anti–Tumor Necrosis Factor Therapy: A Prospective Study in Rheumatoid Arthritis and Spondyloarthritis
Authors' conclusion
In active inflammatory rheumatisms, impaired descending pain modulation, but not thermal pain thresholds, is improved after TNFi treatment
Study context
- Population
- Patients with active rheumatoid arthritis (RA) or spondyloarthritis (SpA) naive to biologic disease-modifying antirheumatic drugs (bDMARDs) or tsDMARDs and starting a tumor necrosis factor inhibitor (TNFi)74 completed six-month follow-up
- Participants
- 100 patients
- Exposure
- Conditioned pain modulation (CPM) effect and thermal pain thresholds at baseline vs six months after TNFi initiation
- RAn = 50
- SpAn = 50
- Outcome
- Pain thresholds and descending pain modulation (CPM effect: change in heat pain threshold after a conditioning stimulus)
- Follow-up
- Six months
Main finding
As reported in the abstract
CPM effect · baseline vs six months
P < 0.001
Observational data: associations, not effects.
Further findings
Without significant pain vs Persistent pain
CPM effect by persistent pain (>3 of 10 on Brief Pain Inventory) · end of follow-up
P = 0.04
Remission or low disease activity vs Active rheumatism
CPM effect by disease activity · end of follow-up
P = 0.01
Original publication
Changes in Descending Pain Modulation During Anti–Tumor Necrosis Factor Therapy: A Prospective Study in Rheumatoid Arthritis and Spondyloarthritis. Arthritis Rheumatol. Published 20 January 2025. doi:10.
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