A RECENT multicentre study has revealed that pain interference (PI) remains a prevalent issue among children with juvenile idiopathic arthritis (JIA), despite advances in treatment. The research aimed to enhance understanding of pain in paediatric JIA patients and identify modifiable factors that contribute to their discomfort.
The cross-sectional observational study evaluated 355 children with JIA across multiple centres. Researchers utilised the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Pain Interference measure, alongside other pain assessments and variables such as demographic information, clinical status, psychosocial factors, and functional abilities.
Findings indicated that 27% of the participants reported moderate to severe PI, with 13.3% experiencing daily pain. PI showed a strong correlation with other pain measures. Notably, factors associated with greater PI included increasing age, shorter disease duration, a higher number of active joints, active disease presence, steroid treatment, and biologic therapy.
All PROMIS psychosocial and functional measures were linked to PI in the expected direction, except for PROMIS Pediatric Physical Activity, which showed no association. In multivariable analyses, only PROMIS Fatigue, PROMIS Mobility, and the interaction between PROMIS Anxiety and disease-modifying antirheumatic drug treatment remained significant.
The study concludes that moderate to severe PI is common in children with JIA and tends to increase with age and disease activity indicators. Fatigue and decreased mobility were more strongly associated with higher PI levels than other factors. The findings support using PI as a straightforward, multidimensional pain measure in routine clinical care. The authors suggest that when high PI is identified, healthcare providers should further assess fatigue, mobility, and disease activity to better manage pain in paediatric JIA patients.
Reference
Randell RA et al. Schanberg, with the CARRA Registry Investigators. Pain Interference in Juvenile Idiopathic Arthritis. J Rheumatol. 2024; 51(11):1119-24.
