Anderson, J

Druce, K

McBeth, J

Mulvey, M

Rashid, A

White Rose Research Online

This is a repository copy of Neuropathic pain is a weak predictor of new onset chronic widespread pain.White Rose Research Online URL for this paper:http://eprints.whiterose.ac.uk/124510/Version: Accepted VersionProceedings Paper:McBeth, J, Mulvey, M orcid.org/0000-0002-6357-3848, Rashid, A et al. (2 more authors) (2017) Neuropathic pain is a weak predictor of new onset chronic widespread pain. In: Annals of the Rheumatic Diseases. Annual European Congress of Rheumatology 2017, 14-17 Jun 2017, Madrid, Spain. BMJ Publishing Group , p. 758. https://doi.org/10.1136/annrheumdis-2017-eular.1642© 2017, Published by the BMJ Publishing Group Limited. This is an author produced version of a paper published in Annals of the Rheumatic Diseases. Uploaded in accordance with the publisher's self-archiving policy. eprints@whiterose.ac.ukhttps://eprints.whiterose.ac.uk/Reuse Items deposited in White Rose Research Online are protected by copyright, with all rights reserved unless indicated otherwise. They may be downloaded and/or printed for private study, or other acts as permitted by national copyright laws. The publisher or other rights holders may allow further reproduction and re-use of the full text version. This is indicated by the licence information on the White Rose Research Online record for the item. Takedown If you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. Medical or Research Professionals/CliniciansTopic area: Clinical topics by area of researchTopic: 33. Epidemiology, risk factors for disease or disease progression Submission N°: EULAR17-1642NEUROPATHIC PAIN IS A WEAK PREDICTOR OF NEW ONSET CHRONIC WIDESPREAD PAINJ. McBeth* 1, M. Mulvey2, A. Rashid1, J. Anderson1, K. Druce11Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, 2Leeds University, Leeds,United KingdomMy abstract has been or will be presented at a scientific meeting during a 12 months period prior to EULAR 2017: NoIs the first author applying for a travel bursary and/or an award  for undergraduate medical students?: NoBackground: Regional pain (e.g. back pain) predicts incident chronic widespread pain (CWP), the clinical hallmark offibromyalgia. Up to 20% of patients with CWP have neuropathic pain (NP). People with CWP and NP report similar paincharacteristics including allodynia (pain in response to normal touch), have common risk factors (age, sex, body mass index, smokingand socioeconomic status) and a shared genetic predisposition. Whether NP is a risk factor for CWP is not known.Objectives: To test the hypothesis that among persons free of CWP, NP would increase the risk of developing CWP.Methods: In a population based study participant’s pain reports were coded and those free of CWP (ACR criteria: pain lasting ≥3months in the axial skeleton and contralateral body quadrants) identified.  Participants also completed the Douleur Neuropathique 4(DN4) (which has 7 sensory descriptors of pain (burning, painful cold, electric shocks, tingling, pins and needles, itching, andnumbness), scores ≥3 indicating NP); demographics (date of birth, sex, English Index of Multiple Deprivation, occupational status);Hospital Anxiety and Depression (HAD) scale; Estimation of Sleep Problem Scale (ESPS); self-reported pain medications (summedto give a total count); and signed consent. Participants were classified as no pain, having some pain that wasn’t neuropathic (NP-;DN4 score <3), or neuropathic pain (NP+; DN4 score ≥3). A follow-up questionnaire mailed 12 months later gathered pain data usingthe methods in the baseline survey. Based upon their pain reports at follow up participants were classified as “new CWP” for thosewho reported pain that satisfied the criteria for CWP, or “not CWP”. Logistic regression estimated the odds of developing new CWPin the NP-, and NP+ groups compared to the no pain group. Results were expressed as odds ratios (OR) with 95% confidenceintervals (CI). Population attributable fractions (PAF) estimated the % of new CWP that would be avoided if participants were notexposed to NP- or NP+.Results: A total of 1162 participants who were free of CWP, completed the DN4 and provided pain data at follow up. Of those 523(45.0%) had no pain at baseline, 562 (48.4%) had NP- and 77 (6.6%) had NP+. New onset CWP was reported by 153 (13.2%)participants; 19 (3.6%) of the no pain group, 108 (19.2%) of the NP- group, and 26 (33.8%) of the NP+ group. After adjusting for ageand sex, compared to the no pain group, the NP- group was 3 times (OR 2.9, 95% CI (2.0, 4.2)) and the NP+ group 4 times (3.9 (2.3,6.4)) more likely to have new CWP at follow up. These relationships were attenuated but persisted after adjustments fordemographics, HAD, ESPS and medication use (NP- (2.9 (1.9, 4.3); NP+ (2.1 (1.1, 4.0)). The PAF was 41.3% (95% CI (25.2, 54.0))for NP- and 6.0% (0.1, 11.6) for NP+. All of the individual DN4 characteristics except painful cold and itching predicted new CWPwith PAF's ranging from 1.6% (0.1, 3.8) for pins and needles to 5.0% (1.1, 8.8) for burning.Conclusions: NP predicts a small number of new onset CWP cases. CWP is highly prevalent in the general population and effectivetreatment of pain not of NP origin will have a significant impact on population levels of CWP.Disclosure of Interest: None declared

Neuropathic pain is a weak predictor of new onset chronic widespread pain

J McBeth

M Mulvey

A Rashid

J Anderson

K Druce

Crossref

FRI0708 Neuropathic pain is a weak predictor of new onset chronic widespread pain

https://eprints.whiterose.ac.uk/124510/1/EULAR17-1642-preview-4.pdf

Neuropathic pain is a weak predictor of new onset chronic widespread pain

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