Determination and Characterization of Patient Subgroups Based on Pain Trajectories in Hand Osteoarthritis

Overview

Journal Rheumatology (Oxford)

Publisher Oxford University Press

Specialty Rheumatology

Date 2023 Jan 17

PMID 36648311

Authors

Coen van der Meulen

Lotte A van de Stadt

Frits R Rosendaal

Jos Runhaar

Margreet Kloppenburg

Affiliations

Soon will be listed here.

Abstract

Objectives: To investigate pain, pain trajectories and their determinants in hand osteoarthritis (OA).

Methods: Data from the HOSTAS (Hand OSTeoArthritis in Secondary care) consisting of consecutive hand OA patients were used. Australian Canadian Osteoarthritis Hand Index (AUSCAN) pain was measured yearly for four years. Patients with complete AUSCAN at ≥2 time points were eligible for longitudinal analysis. Associations between variables of interest and baseline AUSCAN pain were investigated with linear regression. Development of pain over time was modelled using latent class growth analysis (LCGA). Associations of LCGA classes with variables of interest were analysed using multinomial logistic regression adjusted for baseline pain.

Results: A total of 484/538 patients [mean (s.d.) age 60.8 (8.5) years, 86% women, mean (s.d.) AUSCAN pain 9.3 (4.3)] were eligible for longitudinal analysis. Sex, marital and working status, education, disease duration and severity, anxiety and depression scores, lower health-related quality of life (HR-QoL), specific illness perceptions and coping styles were associated with baseline pain. LCGA yielded three classes, characterized by average pain levels at baseline; average pain remained stable over time within classes. Classes with more pain were positively associated with BMI, tender joint count, symptom duration, hand function scores and depression scores, negatively with physical HR-QoL, and education level.

Conclusion: Baseline pain was associated with patient and disease characteristics, and psychosocial factors. LCGA showed three pain trajectories in hand OA patients, with different baseline pain levels and stable pain over time. Classes were distinguished by BMI, education level, disease severity, depression and HR-QoL.

Citing Articles

The associations between sleep problems and pain outcomes in people with hand osteoarthritis - Data from the Nor-hand study.

Bordvik D, Steen Pettersen P, Gloersen M, Mulrooney E, Neogi T, Kjeken I Osteoarthr Cartil Open. 2025; 7(1):100579.

PMID: 40034602 PMC: 11875149. DOI: 10.1016/j.ocarto.2025.100579.

References

Previtali D, Andriolo L, di Laura Frattura G, Boffa A, Candrian C, Zaffagnini S . Pain Trajectories in Knee Osteoarthritis-A Systematic Review and Best Evidence Synthesis on Pain Predictors. J Clin Med. 2020; 9(9). PMC: 7564930. DOI: 10.3390/jcm9092828. View

Gloersen M, Steen Pettersen P, Neogi T, Slatkowsky-Christensen B, Kvien T, Magnusson K . Associations of pain sensitisation with tender and painful joint counts in people with hand osteoarthritis: results from the Nor-Hand study. RMD Open. 2022; 8(1). PMC: 8734025. DOI: 10.1136/rmdopen-2021-001774. View

Kloppenburg M, Kwok W . Hand osteoarthritis--a heterogeneous disorder. Nat Rev Rheumatol. 2011; 8(1):22-31. DOI: 10.1038/nrrheum.2011.170. View

Wesseling J, Bastick A, Ten Wolde S, Kloppenburg M, Lafeber F, Bierma-Zeinstra S . Identifying Trajectories of Pain Severity in Early Symptomatic Knee Osteoarthritis: A 5-year Followup of the Cohort Hip and Cohort Knee (CHECK) Study. J Rheumatol. 2015; 42(8):1470-7. DOI: 10.3899/jrheum.141036. View

Aaronson N, Muller M, Cohen P, Essink-Bot M, Fekkes M, Sanderman R . Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998; 51(11):1055-68. DOI: 10.1016/s0895-4356(98)00097-3. View

Marshall M, Watt F, Vincent T, Dziedzic K . Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management. Nat Rev Rheumatol. 2018; 14(11):641-656. DOI: 10.1038/s41584-018-0095-4. View

Bijsterbosch J, Scharloo M, Visser A, Watt I, Meulenbelt I, Huizinga T . Illness perceptions in patients with osteoarthritis: change over time and association with disability. Arthritis Rheum. 2009; 61(8):1054-61. DOI: 10.1002/art.24674. View

Bastick A, Verkleij S, Damen J, Wesseling J, Hilberdink W, Bindels P . Defining hip pain trajectories in early symptomatic hip osteoarthritis--5 year results from a nationwide prospective cohort study (CHECK). Osteoarthritis Cartilage. 2016; 24(5):768-75. DOI: 10.1016/j.joca.2015.11.023. View

Damman W, Liu R, Kroon F, Reijnierse M, Huizinga T, Rosendaal F . Do Comorbidities Play a Role in Hand Osteoarthritis Disease Burden? Data from the Hand Osteoarthritis in Secondary Care Cohort. J Rheumatol. 2017; 44(11):1659-1666. DOI: 10.3899/jrheum.170208. View

10.

Bellamy N, Campbell J, Haraoui B, Buchbinder R, Hobby K, Roth J . Dimensionality and clinical importance of pain and disability in hand osteoarthritis: Development of the Australian/Canadian (AUSCAN) Osteoarthritis Hand Index. Osteoarthritis Cartilage. 2002; 10(11):855-62. DOI: 10.1053/joca.2002.0837. View

11.

Kroon F, Damman W, van der Plas J, van Beest S, Rosendaal F, van der Heijde D . Self-reported painful joint count and assessor-reported tender joint count as instruments to assess pain in hand osteoarthritis. Rheumatology (Oxford). 2019; 59(5):1094-1098. PMC: 7850158. DOI: 10.1093/rheumatology/kez395. View

12.

Neogi T . The epidemiology and impact of pain in osteoarthritis. Osteoarthritis Cartilage. 2013; 21(9):1145-53. PMC: 3753584. DOI: 10.1016/j.joca.2013.03.018. View

13.

Steen Pettersen P, Neogi T, Magnusson K, Hammer H, Uhlig T, Kvien T . Peripheral and Central Sensitization of Pain in Individuals With Hand Osteoarthritis and Associations With Self-Reported Pain Severity. Arthritis Rheumatol. 2019; 71(7):1070-1077. PMC: 6594897. DOI: 10.1002/art.40850. View

14.

Damman W, Liu R, Kaptein A, Evers A, van Middendorp H, Rosendaal F . Illness perceptions and their association with 2 year functional status and change in patients with hand osteoarthritis. Rheumatology (Oxford). 2018; 57(12):2190-2199. DOI: 10.1093/rheumatology/key231. View

15.

Liu R, Damman W, Kaptein A, Rosendaal F, Kloppenburg M . Coping styles and disability in patients with hand osteoarthritis. Rheumatology (Oxford). 2015; 55(3):411-8. DOI: 10.1093/rheumatology/kev295. View

16.

Slatkowsky-Christensen B, Haugen I, Haugen I, Kvien T . Distribution of joint involvement in women with hand osteoarthritis and associations between joint counts and patient-reported outcome measures. Ann Rheum Dis. 2009; 69(1):198-201. DOI: 10.1136/ard.2008.096792. View

17.

Charlson M, Pompei P, Ales K, MacKenzie C . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-83. DOI: 10.1016/0021-9681(87)90171-8. View

18.

Trouvin A, Perrot S . Pain in osteoarthritis. Implications for optimal management. Joint Bone Spine. 2017; 85(4):429-434. DOI: 10.1016/j.jbspin.2017.08.002. View

19.

Kellgren J, Lawrence J . Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957; 16(4):494-502. PMC: 1006995. DOI: 10.1136/ard.16.4.494. View

20.

Zigmond A, SNAITH R . The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6):361-70. DOI: 10.1111/j.1600-0447.1983.tb09716.x. View