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Mathieu S, Couderc M, Pereira B, Dubost JJ, Malochet-Guinamand S, Tournadre A, Soubrier M, Moisset X. Prevalence of Migraine and Neuropathic Pain in Rheumatic Diseases. J Clin Med 2020; 9:jcm9061890. [PMID: 32560321 PMCID: PMC7356241 DOI: 10.3390/jcm9061890] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/14/2022] Open
Abstract
To investigate the physiopathology of pain in chronic inflammatory rheumatic diseases (CIRDs), we assessed the prevalence of migraine and neuropathic pain in 499 patients with CIRDs. We studied 238 patients with rheumatoid arthritis, 188 with spondyloarthritis (SpA), 72 with psoriatic arthritis (PsA), and 1 unclassified. Migraine was diagnosed according to IHS migraine diagnostic criteria. Neuropathic pain was diagnosed when patients scored at least 3 on the DN4 questionnaire. Participants completed a validated self-assessment questionnaire. Migraine prevalence was 34% (165/484), and it was highest in PsA. Risk factors for migraine were a high level of anxiety, female sex, young age, and TNF-alpha inhibitor treatment (OR = 1.90 (1.13–3.25)). Besides, high disease activity was a risk factor in SpA. Blood CRP level was not significantly associated with migraine. Of 493 patients with CIRDs, 21.5% had chronic pain with neuropathic characteristics. Compared to the French general population, these patients had significantly higher prevalences of migraine (two-fold) and neuropathic pain (three-fold). This study showed that migraine and neuropathic pain frequently occurred in patients with rheumatic diseases. Therefore, upon reporting residual pain, these patients should be checked for the presence of migraine or neuropathic pain, despite adequate clinical control of rheumatic disease.
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Affiliation(s)
- Sylvain Mathieu
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
- Rheumatology Department, Gabriel Montpied Teaching Hospital, 58 Rue Montalembert, 63003 Clermont-Ferrand, France
- Correspondence:
| | - Marion Couderc
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
| | - Bruno Pereira
- Unité de biostatistiques (DRCI), CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Jean-Jacques Dubost
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
| | - Sandrine Malochet-Guinamand
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
| | - Anne Tournadre
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
| | - Martin Soubrier
- Service de Rhumatologie, Université Clermont-Auvergne, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France; (M.C.); (J.-J.D.); (S.M.-G.); (A.T.); (M.S.)
| | - Xavier Moisset
- Neurology Department, Université Clermont Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, F-63000 Clermont Ferrand, France;
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Demyelination during anti-TNFα therapy for ankylosing spondylitis. Mod Rheumatol 2011; 22:303-7. [PMID: 21748364 DOI: 10.1007/s10165-011-0498-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 06/22/2011] [Indexed: 10/18/2022]
Abstract
A 34-year-old ankylosing spondylitis (AS) patient on etanercept for 30 months presented to neurologists with paresthesia of his hands and feet. Magnetic resonance imaging (MRI) scans showed multifocal hyperintense lesions. Symptoms did not improve on stopping the anti-tumor necrosis factor (TNF) agent. Few cases of demyelinating disease occurring after more than 2 years of treatment with anti-TNF agents have been reported in patients with AS. Opthalmologists, internists, neurologists, and rheumatologists need to be aware of these adverse events, as patients may present to any of these specialties many years after treatment.
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