For this study researchers wanted to describe changes in catastrophizing that occur with the start of a new disease-modifying antirheumatic medication (DMARD) and to investigate the link between changes in CDAI and changes in catastrophizing. The Pain Catastrophizing Scale (PCS) was completed by participants in an ongoing multisite observational research before and 12 weeks following DMARD administration. They examined the relationship between changes in CDAI as the exposure and changes in pain catastrophizing as the outcome using multivariable linear regression models. They also used multivariable linear regression models to examine the link between changes in each component of CDAI and changes in PCS. After 12 weeks, CDAI decreased from 22 to 11.5 on a 76-point scale (p < 0.0001) among the 165 rheumatoid arthritis patients with data on CDAI at both time points. On a 10-point numeric rating scale, pain intensity fell from a median of 5 to 3 (p < 0.0001), and catastrophizing decreased from 16.0 to 12.0 on a 52-point PCS (p = 0.0005). Changes in CDAI were positively linked with changes in catastrophizing among the 163 people who had complete data for the regression analysis (standardized β = 0.19, p = 0.01). Changes in assessor global score were most substantially linked with changes in catastrophizing (standardized β = 0.24, p = 0.003).
After starting a new DMARD, pain catastrophizing falls in tandem with disease activity. These findings support the concept of catastrophizing as a dynamic construct that may be modified with therapy aimed at reducing inflammatory disease activity and pain.
Reference:journals.lww.com/jclinrheum/Abstract/2019/08000/Pain_and_Catastrophizing_in_Patients_With.6.aspx