Mélanie Racine1, Marie Hudson2, Murray Baron2, Warren R Nielson3. 1. Lawson Health Research Institute, London, Ontario, Canada; Department of Clinical and Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. 2. Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada. 3. Lawson Health Research Institute, London, Ontario, Canada; Department of Psychology, Western University, London, Ontario, Canada. Electronic address: wnielson@uwo.ca.
Abstract
CONTEXT: Pain and itch are common symptoms reported by patients with systemic sclerosis (SSc; scleroderma), which can markedly diminish function and health-related quality of life (HRQL). OBJECTIVES: The aim of this exploratory study was to examine the impact that pain, itch, and the interaction of both have on function (depressive symptoms, overall disability, fatigue, sleep disturbance) and HRQL in patients with SSc. METHODS: A total of 964 patients from the Canadian Scleroderma Reserch Group Registry completed questionnaires measuring itch and pain severity, function, and HRQL. Multiple regression analyses were performed to examine the impact that pain, itch, and pain × itch interaction have on each outcome variable while controlling for demographic measures. A P-value of ≤0.01 was required for a difference to be deemed statistically significant. RESULTS: Our results revealed that patients with SSc who reported higher pain and itch severity were also more likely to have greater depressive symptoms, overall disability, sleep and fatigue problems, even when demographic measures were controlled for (P-values ≤0.001). Similar results were obtained for HRQL, regardless of the domains (P-values ≤0.001). A significant association between pain × itch interaction and sleep (P = 0.002), physical functioning (P = 0.003), and general health (P ≤ 0.001) variables also was found. Further investigation of the nature of the pain × itch interaction showed that the effect of pain severity on outcome variables diminishes as itch severity increases. CONCLUSION: Both pain and itch appear to have a detrimental impact on functioning and HRQL in patients with SSc, suggesting that more targeted approaches to symptom management are warranted.
CONTEXT: Pain and itch are common symptoms reported by patients with systemic sclerosis (SSc; scleroderma), which can markedly diminish function and health-related quality of life (HRQL). OBJECTIVES: The aim of this exploratory study was to examine the impact that pain, itch, and the interaction of both have on function (depressive symptoms, overall disability, fatigue, sleep disturbance) and HRQL in patients with SSc. METHODS: A total of 964 patients from the Canadian Scleroderma Reserch Group Registry completed questionnaires measuring itch and pain severity, function, and HRQL. Multiple regression analyses were performed to examine the impact that pain, itch, and pain × itch interaction have on each outcome variable while controlling for demographic measures. A P-value of ≤0.01 was required for a difference to be deemed statistically significant. RESULTS: Our results revealed that patients with SSc who reported higher pain and itch severity were also more likely to have greater depressive symptoms, overall disability, sleep and fatigue problems, even when demographic measures were controlled for (P-values ≤0.001). Similar results were obtained for HRQL, regardless of the domains (P-values ≤0.001). A significant association between pain × itch interaction and sleep (P = 0.002), physical functioning (P = 0.003), and general health (P ≤ 0.001) variables also was found. Further investigation of the nature of the pain × itch interaction showed that the effect of pain severity on outcome variables diminishes as itch severity increases. CONCLUSION: Both pain and itch appear to have a detrimental impact on functioning and HRQL in patients with SSc, suggesting that more targeted approaches to symptom management are warranted.
Authors: Henrik Pettersson; Helene Alexanderson; Janet L Poole; Janos Varga; Malin Regardt; Anne-Marie Russell; Yasser Salam; Kelly Jensen; Jennifer Mansour; Tracy Frech; Carol Feghali-Bostwick; Cecília Varjú; Nancy Baldwin; Matty Heenan; Kim Fligelstone; Monica Holmner; Matthew R Lammi; Mary Beth Scholand; Lee Shapiro; Elizabeth R Volkmann; Lesley Ann Saketkoo Journal: Best Pract Res Clin Rheumatol Date: 2021-07-01 Impact factor: 4.991
Authors: Alain Lescoat; Susan L Murphy; David Roofeh; John D Pauling; Michael Hughes; Robert Sandler; François Zimmermann; Rachel Wessel; Whitney Townsend; Lorinda Chung; Christopher P Denton; Peter A Merkel; Virginia Steen; Yannick Allanore; Francesco Del Galdo; Dominique Godard; David Cella; Sue Farrington; Maya H Buch; Dinesh Khanna Journal: J Scleroderma Relat Disord Date: 2020-10-05
Authors: Sébastien Peytrignet; Christopher P Denton; Mark Lunt; Roger Hesselstrand; Luc Mouthon; Alan Silman; Xiaoyan Pan; Edith Brown; László Czirják; Jörg H W Distler; Oliver Distler; Kim Fligelstone; William J Gregory; Rachel Ochiel; Madelon Vonk; Codrina Ancuta; Voon H Ong; Dominique Farge; Marie Hudson; Marco Matucci-Cerinic; Alexandra Balbir-Gurman; Øyvind Midtvedt; Alison C Jordan; Wendy Stevens; Pia Moinzadeh; Frances C Hall; Christian Agard; Marina E Anderson; Elisabeth Diot; Rajan Madhok; Mohammed Akil; Maya H Buch; Lorinda Chung; Nemanja Damjanov; Harsha Gunawardena; Peter Lanyon; Yasmeen Ahmad; Kuntal Chakravarty; Søren Jacobsen; Alexander J MacGregor; Neil McHugh; Ulf Müller-Ladner; Gabriela Riemekasten; Michael Becker; Janet Roddy; Patricia E Carreira; Anne Laure Fauchais; Eric Hachulla; Jennifer Hamilton; Murat Inanç; John S McLaren; Jacob M van Laar; Sanjay Pathare; Susanna Proudman; Anna Rudin; Joanne Sahhar; Brigitte Coppere; Christine Serratrice; Tom Sheeran; Douglas J Veale; Claire Grange; Georges-Selim Trad; Ariane L Herrick Journal: Rheumatology (Oxford) Date: 2018-02-01 Impact factor: 7.580