Institution: | 1. Inserm U 987, centre d’évaluation et traitement de la douleur, hôpital Cochin, université Paris Descartes, 75014 Paris, France;2. Service de rhumatologie, centre hospitalier Henri-Mondor, 94010 Créteil, France;3. Université Paris XII, 94010 Créteil, France;4. Service de rhumatologie, CHRU de Tours, 37044 Tours cedex, France;5. Université de Tours, 37 Tours, 37020 Tours cedex 1, France |
Abstract: | ObjectivesTo study daily pain trajectories (DPT) in patients with knee (KOA) and hip osteoarthritis (HOA) over a one-month period and identify relationships with patients characteristics and acceptability.MethodsThis prospective, multicenter cohort study was conducted in France by 602 GPs, on outpatients, with painful KOA or HOA. Patients were asked to fill-in a 28-days daily pain diary. DPT were determined by the difference between daily pain and mean pain over 28 days. Pain peaks were defined as an increase of more than 1 point above the mean for up to three consecutive days. The number of pain peaks over the 28 day period allowed classifying the patient's pain trajectory as either “stable” or “unstable”. A logistic regression model was used to identify predicting factors associated with stable pain profile.ResultsOverall, 1645 patients were included and 886 were analyzed, (56% women, 67.8?years, BMI 27.6?kg/m2, pain 6.0, KOA 71.3%). At one month, stable DPT was found in 59.5% of the patients whatever OA location. In HOA, a shorter duration of disease and pain, a greater disability and in KOA, a more recent disease, morning stiffness?≥?15?minutes and flare-up were independent factors associated with “stable” DPT. At one month, acceptable pain state was more frequent (65.4%) in patients with stable profiles.ConclusionIn lower limb OA, pain is mostly stable over a 28-days period. Pain is better accepted when stable, with different determining factors according location. DPT should be considered when establishing HOA and KOA management. |