@article{6c39af01f5e44cb382467b2f03ebf36f,
title = "Pain and Catastrophizing in Patients with Rheumatoid Arthritis: An Observational Cohort Study",
abstract = "The aims of this study were to define changes in catastrophizing that occur with initiation of a new disease-modifying antirheumatic drug (DMARD) and to examine the relationship between changes in Clinical Disease Activity Index (CDAI) and changes in catastrophizing. Methods Participants in an ongoing multisite, observational study completed the Pain Catastrophizing Scale (PCS) before and 12 weeks after DMARD initiation. We used multivariable linear regression models to examine the association between changes in CDAI as the exposure and change in pain catastrophizing as the outcome. We also assessed the relationship between changes in each component of CDAI and change in PCS, using multivariable linear regression models. Results Among the 165 rheumatoid arthritis patients with data on CDAI at both time points, CDAI decreased from 22 to 11.5 on a 76-point scale (p < 0.0001) after 12 weeks. Pain intensity decreased from a median of 5 to 3 on a 10-point numeric rating scale (p < 0.0001), and catastrophizing decreased, from 16.0 to 12.0 on the 52-point PCS (p = 0.0005). Among the 163 with complete data for the regression analysis, changes in CDAI were positively correlated with changes in catastrophizing (standardized β = 0.19, p = 0.01). Of the components of the CDAI, change in assessor global score was most strongly associated with changes in catastrophizing (standardized β = 0.24, p = 0.003). Conclusions Pain catastrophizing decreases, in conjunction with disease activity, after initiation of a new DMARD. These findings provide support for catastrophizing as a dynamic construct that can be altered with treatment directed at decreasing inflammatory disease activity and pain.",
keywords = "catastrophizing, disease activity, pain, rheumatoid arthritis",
author = "Cohen, {Ezra M.} and Edwards, {Robert R.} and Bingham, {Clifton O.} and Kristine Phillips and Bolster, {Marcy B.} and Moreland, {Larry W.} and Tuhina Neogi and Wendy Marder and Alyssa Wohlfahrt and Daniel Clauw and Lee, {Yvonne C.}",
note = "Funding Information: Funding: The CPIRA cohort was funded by NIH grant AR064850. E.C.{\textquoteright}s work was conducted with support from Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic health care centers. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University, and its affiliated academic health care centers, or the National Institutes of Health. C.B.{\textquoteright}s work was funded in part by NIH/NIAMS P30-AR053503 Cores A and D, and by awards SC14-1401-10818 and IP2-PI000737 from the Patient Centered Outcomes Research Institute. All statements in this report, including its conclusions, are solely those of the authors and do not represent those of Patient Centered Outcomes Research Institute, its Methodology Committee, or its Board of Governors, or of the NIH or NIAMS. T.N. reports funding from P60 AR47785, R01 AR062506, K24 AR070892, and 5R01AR064850-03. K.P.{\textquoteright}s work was funded in part by NIH/NIAMS K23AR060241 and UL1TR000433. Funding Information: Competing Interests: C.B. has served as a consultant to Eli Lilly, Janssen, and UCB regarding patient reported outcomes assessment. M.B. reports funding from Eli Lilly for a clinical trial as well as trainee funding from Amgen. D.C. has received consulting fees from Pfizer, Eli Lilly, Nuvo, Cerephex, Tonix, Abbott, Forest Labs, Johnson & Johnson, Merck, Purdue Pharma, Sammumed, Zynerba, Astellas Pharma, Williams & Connolly LLP, and Therevance. He has also received research support from Pfizer, Cypress Biosciences, Forest, Merck, Nuvo, and Cerephex. Y.L. has received a research grant from Pfizer and has stock in Express Scripts. All other authors report no competing interests. Publisher Copyright: {\textcopyright} Wolters Kluwer Health, Inc. All rights reserved.",
year = "2019",
month = aug,
day = "1",
doi = "10.1097/RHU.0000000000000834",
language = "English (US)",
volume = "25",
pages = "232--236",
journal = "Journal of Clinical Rheumatology",
issn = "1076-1608",
publisher = "Lippincott Williams and Wilkins",
number = "5",
}