Pain Phenotypes and their Underlying Mechanisms in Inflammatory Arthritis (PUMIA)

Research summary

Controlling persistent pain is a significant unmet need for people living with Inflammatory arthritis (IA). There is emerging evidence that patients with IA exhibit different types of pain and central sensitisation contributes significantly to chronic pain. The treatment for different pain types will differ. One way in which we might rapidly improve the treatment of pain in IA is by identifying an individual’s pain type in the clinic, then tailor their pain treatment accordingly. Currently this is not routine practice and is limited by our understanding of different pain types in inflammatory arthritis and our ability to easily measure them in the clinical setting. We will comprehensively phenotype pain (describe the type of pain) in patients with IA and observe whether pain types change over time. We will use measures of central sensitisation (painDETECTquestionnaire, clinical pain perception tests) and peripheral sensitisation (response to intra-articular injection of lidocaine, joint ultrasound) to identify pain phenotypes in a cross-sectional and longitudinal cohort of patient with IA. We will also correlate these to measures of disease activity, patient reported outcomes and measures of psychological distress. We will take blood and joint fluid samples and identify whether certain immune cells and cytokines correlate with certain pain types. Understanding the key immune molecules and cells which contribute to pain then has the potential to lead to the development of biomarkers of pain and to help guide appropriate treatments which target these molecules. Finally, we will perform a qualitative study to identify descriptors of pain used by patients with distinct pain phenotypes. These descriptors of pain, alongside the painDETECT questionnaire and the response to intra-articular injection of lidocaine will allow a simple assessment of pain phenotype in the clinical setting and enable clinicians to provide tailored treatments to their patients.

Principal Investigator

Dr Shing (Tom) Law

Contact us

Email: gail.lang@ndorms.ox.ac.uk

IRAS number

302190