The effect of central sensitization on disease activity measures, quality of life and clinical parameters in axial spondyloarthritis: a cross-sectional study

Objective: Despite biological drug therapy, pain remains a persistent complaint in patients with axial spondyloarthritis (axSpA). We aimed to investigate the effect of central sensitization (CS) on disease activity measures, quality of life, and clinical parameters in axSpA patients.Methods: We consecutively recruited axSpA patients who were followed up at our rheumatology outpatient clinic, and age- and sex-matched controls in this cross-sectional study. The central sensitization inventory, douleur neuropathique 4 (DN4) questions, and 2010 American College of Rheumatology fibromyalgia (FM) diagnostic criteria were applied to all individuals. The patients' clinical parameters were recorded. The data of the patient and control groups were compared.Results: Of the 116 axSpA patients (57 female) and 95 controls (46 female) who participated in this study, CS was determined in 46.6% of axSpA patients and 13.7% of controls (p<0.001). Patients with CS exhibited high disease activity, and poor quality of life and functionality than without it (all p<0.001). The median CS, frequency of FM and frequency of neuropathic pain were higher in patients than in the controls (all p<0.001). CS-related conditions, including anxiety and depression, were higher in axSpA patients than in controls (both p<0.05).Conclusion: The results showed that CS was common in axSpA patients, and patients with CS had higher disease activity, worse quality of life, and worse functional status than those without CS.