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Neuropathic pain in ankylosing spondylitis: a meta-analysis

Neuropathischer Schmerz bei ankylosierender Spondylitis – eine Metaanalyse

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Abstract

Aim

The aim of this study was to compare demographic characteristics, disease activity, functional status, and quality of life between ankylosing spondylitis (AS) with neuropatic pain (NP) and AS without NP (Non-NP).

Methods

The MEDLINE via PubMed, Cochrane, Scopus, and Embase database, from the earliest available date of indexing through December 20, 2018, were searched for comparative studies evaluating NP in AS patients. Two authors performed the data extraction independently. Any discrepancies were resolved by consensus.

Results

Four comparative studies were identified. There was no statistically significant difference in terms of age, body mass index, symptom duration, and inflammatory markers, such as erythrocyte sedimentation rate and C‑reactive protein between NP and Non-NP. The sex ratios (F/M) were approximately 1/1 in NP and 1/2 in Non-NP and the proportion of human leukocyte antigen (HLA) B27-positive patients in NP and Non-NP was 65.7% and 83.0%, respectively. NP patients had significantly higher visual analogue scale pain scores, higher Bath Ankylosing Spondylitis Disease Activity Index, higher Bath Ankylosing Spondylitis Functional Index, and lower SF-Item Short Form physical component scores compare to Non-NP patients.

Conclusion

The current meta-analysis showed that NP patients had significantly higher pain severity, higher disease activity and lower quality of life than Non-NP patients. The sex ratio (F/M) and proportion of HLA-B27 positive patients were different between the two groups. Further well-designed studies are needed to substantiate our results.

Zusammenfassung

Zielsetzung

Ziel der vorliegenden Studie war es, demografische Eigenschaften, die Krankheitsaktivität, den funktionellen Status und die Lebensqualität bei ankylosierender Spondylitis (AS) mit neuropathischem Schmerz (NP) und ohne NP (Non-NP) zu vergleichen.

Methoden

In der MEDLINE- (über PubMed), Cochrane‑, Scopus- und Embase-Datenbank wurde von den ältesten verfügbaren Indexdaten bis 20. Dezember 2018 nach vergleichenden Studien zu NP bei Patienten mit AS gesucht. Zwei Autoren führten unabhängig voneinander die Datenextraktion durch. Jegliche Unstimmigkeiten wurden im Konsens ausgeräumt.

Ergebnisse

Vier vergleichende Studien wurden gefunden. Zwischen NP und Nicht-NP fanden sich keine statistisch signifikanten Unterschiede in Bezug auf Alter, Body-Mass-Index, Symptomdauer und Entzündungsmarker wie Blutkörperchensenkungsgeschwindigkeit und C‑reaktives Protein. Das Geschlechtsverhältnis (weiblich/männlich) betrug ungefähr 1/1 bei NP und 1/2 bei Nicht-NP, der Anteil der Patienten mit Human-leukocyte-antigen(HLA)-B27-Positivität belief sich bei NP auf 65,7% und bei Nicht-NP auf 83,0%. Patienten mit NP hatten im Vergleich zu Patienten ohne NP signifikant höhere Schmerzwerte auf einer visuellen Analogskala, höhere Werte auf dem Bath Ankylosing Spondylitis Disease Activity Index und Bath Ankylosing Spondylitis Functional Index sowie geringere Werte bezüglich der körperlichen Komponente von SF-Item Short Form.

Schlussfolgerung

Gemäß dieser aktuellen Metaanalyse weisen Patienten mit NP eine signifikant höhere Schmerzintensität, höhere Krankheitsaktivität und geringere Lebensqualität auf als Patienten ohne NP. Hinsichtlich des Geschlechtsverhältnisses (weiblich/männlich) und des Anteils HLA-B27-positiver Patienten fanden sich Unterschiede zwischen den beiden Gruppen. Weitere gut konzipierte Studien sind erforderlich, um diese Ergebnisse zu bestätigen.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Bonebarum Hospital, Yangsan, Korea (Republic of)

    T. W. Kim

  2. BioMedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea (Republic of)

    S. M Son

  3. BioMedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, 49241, Busan, Korea (Republic of)

    J. S. Lee MD, PhD

Authors
  1. T. W. Kim
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  2. S. M Son
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  3. J. S. Lee MD, PhD
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Corresponding author

Correspondence to J. S. Lee MD, PhD.

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Conflict of interest

T.W. Kim, S.M. Son, and J.S. Lee declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

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U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

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Kim, T.W., Son, S.M. & Lee, J.S. Neuropathic pain in ankylosing spondylitis: a meta-analysis. Z Rheumatol 79, 95–102 (2020). https://doi.org/10.1007/s00393-019-0654-3

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  • DOI: https://doi.org/10.1007/s00393-019-0654-3

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