Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Pain and Catastrophizing in Patients with RA

J Clin Rheumatol; ePub 2018 Jun 22; Cohen, et al

Pain catastrophizing decreases in rheumatoid arthritis (RA), in conjunction with disease activity, after initiation of a new disease-modifying antirheumatic drug (DMARD), according to a recent study. These findings provide support for catastrophizing as a dynamic construct that can be altered with treatment directed at decreasing inflammatory disease activity and pain. Participants in an ongoing multisite, prospective observational study completed the Pain Catastrophizing Scale (PCS) before and 12 weeks after DMARD initiation. Researchers used multivariable linear regression models to examine the association between changes in Clinical Disease Activity Index (CDAI) as the exposure and change in pain catastrophizing as the outcome. They found:

  • Among the 165 RA patients with data on CDAI at both time points, CDAI decreased from 22 to 11.5 on a 76-point scale after 12 weeks.
  • Pain intensity decreased from a median of 5 to 3 on a 10-point numeric rating scale, and catastrophizing decreased, from 16.0 to 12.0 on the 52-point PCS.
  • Among the 163 with complete data for the regression analysis, changes in CDAI were positively correlated with changes in catastrophizing (standardized β = 0.19).


Cohen EM, Edwards RR, Bingham C, et al. Pain and catastrophizing in patients with rheumatoid arthritis: A prospective observational cohort study. [Published online ahead of print June 22, 2018]. J Clin Rheumatol. doi:10.1097/RHU.0000000000000834.

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