Central Aspects of Pain in Rheumatoid Arthritis (CAP-RA)
Research type
Research Study
Full title
Improving Pain Outcomes in Rheumatoid Arthritis; Detecting the Contribution of Central Pain Mechanisms.
IRAS ID
269143
Contact name
David A Walsh
Contact email
Sponsor organisation
University of Nottingham
Duration of Study in the UK
2 years, 1 months, 1 days
Research summary
Research Summary
Background: Rheumatoid Arthritis (RA) is an autoimmune condition that mostly affects the joints and long term pain and fatigue are common problems. We believe the central nervous system (brain and spinal cord) may make pain and fatigue worse through a process called central sensitization. We have designed a new questionnaire (CAP-RA) to try and measure central sensitization. In the future, we believe that this questionnaire might be used to show which people will respond to certain treatments for pain.
Objectives:
1.Optimise and measure the psychometric properties of CAP-RA in people with Rheumatoid Arthritis.
2.Measure the ability of CAP-RA to identify people with active RA destined to have poor fatigue outcome despite therapy.
Secondary Objectives
1.Investigate factors associated with worse RA pain
2.Compare CAP-RA’s persistent pain performance to other pain outcome predictors
3.Derive CAP-RA scoring recommendations for stratification in clinical trials and clinical practice
4.Examine the association between central pain sensitization and fatigue.
5.Examine 12-week course of pain and fatigue in RA
Methods:
50 people with RA will complete the CAP-RA questionnaire, answer questions about pain, fatigue and other areas of health, and undergo other tests and scans to measure pain, fatigue, inflammation, and central sensitization. We will use their data to determine how well CAP-RA works in people with painful RA and measure the extent to which pain and fatigue are related to central sensitization.
We will also see if CAP-RA can be used to predict who will still have unacceptable pain, despite treatment.
Impact: We anticipate that CAP-RA will identify which people can benefit from treatments over and above those treating inflammation. We will use findings from this study to develop new ways of treating people with RA in order to improve their pain and fatigue.Summary of Results
A total of 194 people with Rheumatoid Arthritis (RA) were recruited from Nottinghamshire NHS Trusts. Additional data was also included from Nottingham, London and Cardiff. 380 people with RA were included in the analysis (73% female, median age of 63 years) with a median 'average pain over the past four weeks' 6/10, and Central Aspects of Pain (CAP) questionnaire scores 9/16. The CAP questionnaires demonstrated reliability and validity in individuals with RA. The CAP questionnaire explains a large proportion (42%) of pain variance and may reflect central nervous system (brain and spinal cord) contributions to or a consequence of pain.
REC name
North of Scotland Research Ethics Committee 1
REC reference
20/NS/0036
Date of REC Opinion
27 Mar 2020
REC opinion
Favourable Opinion