Big Flaw in RA Treatment Success Record: Remaining Pain

Do you think current treatment of rheumatoid arthritis is a success story? Jon Lampa MD of the Karolinska University Hospital in Sweden has a different perspective. He points to what he calls a "big problem:" Residual pain.

In rheumatoid arthritis, early studies don't correlate inflammation with pain,he observes, and they suggesedt that many patients continue to have pain despite treatment with DMARDs or other biologicals. In this brief video, he describes studies using Swedish databases including more than 8000 patients and controls that inquired about how many patients continue to experience pain after three months of treatment.

"We found that about a third of patients with good [objective] response actually have remaining pain and that of patients with moderate response about two thirds ... have remaining pain," he says, describing research reported at the American College of Rheumatology annual meeting in San Diego. About a fifth of patients actually had increasing pain.

The study also looked for, and found, variables associated with pain that continues despite treatment

"We have to see this as a challenge for using other means of decreasing this pain," Dr. Lampa concludes. "I think it's important to acknowledge this at the beginning, at baseline, for every patient, and to actually make a more thorough pain analysis of more and more patients."