Exploring the complexities of pain phenotypes: OMERACT 2023 chronic pain working group workshop

Tim Pickles, Mary Cowern, Robin Christensen, Sabrina M Nielsen, Lee S Simon, Caitlin M P Jones, Lara J Maxwell, Beverley Shea, Vibeke Strand, Zahi Touma, Karine Toupin-April, Philip Mease, Ernest Choy

Abstract

OBJECTIVE: To educate and discuss pain mechanisms (nociceptive, neuropathic, nociplastic) illuminating its possible impact when measuring different outcomes, which may modify, confound and potentially bias the outcome measures applied across various aspects of Rheumatic Musculoskeletal Diseases (RMDs) clinical trials.

METHODS: In the plenary presentations, PM lectured on different pain mechanisms and impact on disease activity assessment. Data from two data sets of RMDs patients, which assessed the prevalence and impact of nociplastic pain were presented and reviewed. Audience breakout group sessions and polling were conducted.

RESULTS: Mixed pain etiologies may differentially influence disease activity assessment and therapeutic decision-making. Polling demonstrated a consensus on the need to assess different types of pain as a phenotype, as it constitutes an important contextual factor (a variable that is not an outcome of the trial, but needs to be recognized [and measured] to understand the study results), and to standardize across RMDs.

CONCLUSION: There is need for a standardized pain measure that can differentiate underlying pain mechanisms.

Original languageEnglish
Article number152342
JournalSeminars in Arthritis and Rheumatism
Volume64
Pages (from-to)152342
ISSN0049-0172
DOIs
Publication statusPublished - Feb 2024

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