rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2024-535-541rsp-3640Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHЦентральная сенситизация снижает удовлетворенность своим состоянием пациентов с ревматоидным артритом. Данные проспективного исследованияCentral sensitization reduces the satisfaction of patients with rheumatoid arthritis. The data of prospective studyhttps://orcid.org/0000-0002-8627-5341ПотаповаА. С.PotapovaA. S.

Потапова Алена Сергеевна

115522, Москва, Каширское шоссе, 34а

Alena Potapova

115522, Moscow, Kashirskoye Highway, 34A

dr.aspotapova@mail.ruhttps://orcid.org/0000-0002-1391-0711КаратеевА. Е.KarateevA. E.

115522, Москва, Каширское шоссе, 34а

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0001-5103-5447ПолищукЕ. Ю.PolishchukE. Yu.

115522, Москва, Каширское шоссе, 34а

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0009-0002-0634-5627ШолкинаП. А.SholkinaP. A.

115522, Москва, Каширское шоссе, 34а

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-2475-8620ФилатоваЕ. С.FilatovaE. S.

115522, Москва, Каширское шоссе, 34а

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0001-5382-6357АмирджановаВ. Н.AmirjanovaV. N.

115522, Москва, Каширское шоссе, 34а

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-6068-3080ЛилаА. М.LilaA. M.

115522, Москва, Каширское шоссе, 34а

125993, Москва, ул. Баррикадная, 2/1, стр. 1

115522, Moscow, Kashirskoye Highway, 34A

125993, Moscow, Barrikadnaya str., 2/1, building 1

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииРоссияV.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian FederationRussian Federation202401112024625535541Copyright © Потапова А.С., Каратеев А.Е., Полищук Е.Ю., Шолкина П.А., Филатова Е.С., Амирджанова В.Н., Лила А.М., 20242024Потапова А.С., Каратеев А.Е., Полищук Е.Ю., Шолкина П.А., Филатова Е.С., Амирджанова В.Н., Лила А.М.Potapova A.S., Karateev A.E., Polishchuk E.Y., Sholkina P.A., Filatova E.S., Amirjanova V.N., Lila A.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3640

Центральная сенситизация (ЦС) – патофизиологический феномен, играющий принципиальную роль в развитии хронической боли и фибромиалгии. Наличие ЦС может существенно ухудшать состояние больных ревматоидным артритом (РА) и снижать ответ на противоревматическую терапию.Цель исследования – оценить влияние центральной сенситизации на удовлетворенность своим состоянием у пациентов с ревматоидным артритом.Материал и методы. Исследуемую группу составил 521 пациент, наблюдавшийся в клинике ФГБНУ «НИИР им. В.А. Насоновой» в 2021–2022 гг. с достоверным диагнозом РА, соответствующим критериям Европейского альянса ревматологических ассоциаций / Американской коллегии ревматологов (ACR/EULAR, American College of Rheumatology / European Alliance of Associations for Rheumatology) 2010 г. В этой группе было 82,3% женщин; средний возраст составлял 52,0±14,3 года; отмечалась умеренная или высокая активность заболевания (оценка по DAS28-СРБ (Disease Activity Score 28 с определением уровня C-реактивного белка) – в среднем 4,7±1,0). В ходе госпитализации всем пациентам проводилась коррекция индивидуальной терапевтической схемы. На момент выписки терапия генно-инженерными биологическими препаратами (ГИБП) и ингибиторами янус-киназ (иJAK) была продолжена, назначена или изменена у 364 (69,8%) пациентов. Наличие ЦС определялось по опросникам CSI (Central Sensitisation Inventory) и PainDETECT. Удовлетворенность своим состоянием оценивалась в ходе телефонного опроса по индексу PASS (Patient Acceptable Symptom State) через 6 мес. после выписки из стационара.Результаты. Признаки ЦС по опроснику CSI (≥40 баллов) были отмечены у 56,0%, по опроснику PainDETECT (>18 баллов) – у 22,5% пациентов. Телефонный опрос через 6 мес. удалось провести у 473 (90,8%) пациентов. Приемлемым свое состояние (PASS «+») считали 52,0% опрошенных. PASS «+» статистически значимо чаще отмечался у пациентов, получавших ГИБП или иJAK, в сравнении с получавшими только синтетические базисные противовоспалительные препараты (сБПВП): 65,0% и 33,6% соответственно (p<0,001). Индекс PASS «+» был отмечен у 41,7% пациентов с признаками ЦС и у 65,0% без признаков ЦС по CSI (p<0,001), у 40,6% с признаками ЦС и у 55,6% без признаков ЦС по PainDETECT (p<0,001). Статистически значимо более низкая частота PASS «+» наблюдалась у пациентов с ЦС как на фоне приема ГИБП или иJAK, так и на фоне приема только сБПВП.Заключение. ЦС снижает удовлетворенность пациентов с РА своим состоянием на фоне активной противоревматической терапии, включая ГИБП или иJAK.

Central sensitization (CS) is a pathophysiological phenomenon that plays a fundamental role in the development of chronic pain and fibromyalgia. The presence of CS can significantly worsen the condition of patients with rheumatoid arthritis (RA) and reduce the response to antirheumatic therapy.The aim of the study – to evaluate the effect of central sensitization on satisfaction in patients with rheumatoid arthritis.Material and methods. The study group consisted of 521 patients with a reliable diagnosis of RA (ACR/EULAR (American College of Rheumatology / European Alliance of Associations for Rheumatology) 2010 criteria), 82.3% of women, 52.0±14.3 years old, with moderate and high disease activity (DAS28-CRP (Disease Activity Score with C-reactive protein) – 4.7±1.0), observed at the clinic of the V.A. Nasonova Research Institute of Rheumatology in 2021– 2022. During hospitalization, all patients underwent correction of the individual therapeutic regimen. At the time of discharge, therapy with genetically engineered biologic DMARDs or Janus kinase inhibitors (JAKi) was continued, induced or modified in 364 patients (69.8%). The presence of a CS was determined by the CSI (Central Sensitisation Inventory) and painDETECT questionnaires. Satisfaction with their condition was assessed during a telephone survey using the PASS index (patient acceptable symptom state) 6 months after discharge from the hospital.Results. Signs of CS according to the CSI questionnaire (≥40 points) were noted in 56.0%, according to the pain- DETECT questionnaire (>18 points) – in 22.5% of patients. A telephone survey was conducted after 6 months in 473 patients (90.8%). 52.0% of respondents considered their condition acceptable (PASS “+”). PASS “+” was significantly more common in patients receiving biologic DMARDs or JAKi, compared with those receiving only synthetic (s) DMARDs: 65.0% and 33.6% (p<0.001). In patients with signs of CS according to CSI, the PASS index “+” was noted in 41.7%, without signs of CS in 65.0% (p<0.001), with signs of CS according to painDETECT, the PASS index “+” was noted in 40.6%, without signs of CS in 55.6% (p<0.001). A significantly lower frequency of PASS “+” was observed in patients with CS both on the background of taking biologic DMARDs or JAKi, and on the background of taking only sDMARDs.

ревматоидный артритудовлетворенностьPASSцентральная сенситизацияCSIPainDETECTГИБПингибиторы JAKБПВПrheumatoid arthritissatisfactionPASScentral sensitizationCSIpainDETECTbiologic DMARDsJAK inhibitorsDMARDsРабота выполнена в рамках фундаментальной темы (номер государственного задания PK 122040400051-3). Исследование не имело спонсорской поддержки.ReferencesНасонов ЕЛ, Олюнин ЮА, Лила АМ. Ревматоидный артрит: проблемы ремиссии и резистентности к терапии. Научно-практическая ревматология. 2018;56(3):263-271.Nasonov EL, Olyunin YuA, Lila AM. Rheumatoid arthritis: The problems of remission and therapy resistance. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2018;56(3):363-271 (In Russ.). doi: 10.14412/1995-4484-2018-263-271Smolen JS, Landewé RBM, Bijlsma JWJ, Burmester GR, Dougados M, Kerschbaumer A, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020;79(6):685-699. doi: 10.1136/annrheumdis-2019-216655Smolen JS, Landewé RBM, Bijlsma JWJ, Burmester GR, Dougados M, Kerschbaumer A, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020;79(6):685-699. doi: 10.1136/annrheumdis-2019-216655Aletaha D. Precision medicine and management of rheumatoid arthritis. J Autoimmun. 2020;110:102405. doi: 10.1016/j.jaut.2020.102405Aletaha D. Precision medicine and management of rheumatoid arthritis. J Autoimmun. 2020;110:102405. doi: 10.1016/j.jaut.2020.102405Westerlind H, Glintborg B, Hammer HB, Saevarsdottir S, Krogh NS, Hetland ML, et al. Remission, response, retention and persistence to treatment with disease-modifying agents in patients with rheumatoid arthritis: A study of harmonised Swedish, Danish and Norwegian cohorts. RMD Open. 2023;9(3):e003027. doi: 10.1136/rmdopen-2023-003027Westerlind H, Glintborg B, Hammer HB, Saevarsdottir S, Krogh NS, Hetland ML, et al. Remission, response, retention and persistence to treatment with disease-modifying agents in patients with rheumatoid arthritis: A study of harmonised Swedish, Danish and Norwegian cohorts. RMD Open. 2023;9(3):e003027. doi: 10.1136/rmdopen-2023-003027Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS, et al. Rheumatoid arthritis. Nat Rev Dis Primers. 2018;4: 18001.doi: 10.1038/nrdp.2018.1Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS, et al. Rheumatoid arthritis. Nat Rev Dis Primers. 2018;4: 18001.doi: 10.1038/nrdp.2018.1Sarzi-Puttini P, Zen M, Arru F, Giorgi V, Choy EA. Residual pain in rheumatoid arthritis: Is it a real problem? Autoimmun Rev. 2023;22(11):103423. doi: 10.1016/j.autrev.2023.103423Sarzi-Puttini P, Zen M, Arru F, Giorgi V, Choy EA. Residual pain in rheumatoid arthritis: Is it a real problem? Autoimmun Rev. 2023;22(11):103423. doi: 10.1016/j.autrev.2023.103423Takanashi S, Kaneko Y, Takeuchi T. Characteristics of patients with difficult-to-treat rheumatoid arthritis in clinical practice. Rheumatology (Oxford). 2021;60(11):5247-5256. doi: 10.1093/rheumatology/keab209Takanashi S, Kaneko Y, Takeuchi T. Characteristics of patients with difficult-to-treat rheumatoid arthritis in clinical practice. Rheumatology (Oxford). 2021;60(11):5247-5256. doi: 10.1093/rheumatology/keab209Lee YC, Bingham CO 3rd, Edwards RR, Marder W, Phillips K, Bolster MB, et al. Association between pain sensitization and disease activity in patients with rheumatoid arthritis: A cross-sectional study. Arthritis Care Res (Hoboken). 2018;70(2):197-204. doi: 10.1002/acr.23266Lee YC, Bingham CO 3rd, Edwards RR, Marder W, Phillips K, Bolster MB, et al. Association between pain sensitization and disease activity in patients with rheumatoid arthritis: A cross-sectional study. Arthritis Care Res (Hoboken). 2018;70(2):197-204. doi: 10.1002/acr.23266Jansen N, Ten Klooster PM, Vonkeman HE, van den Berg B, Buitenweg JR. Further evaluation of inflammatory and noninflammatory aspects of pain in rheumatoid arthritis patients. Rheumatol Adv Pract. 2023;7(3):rkad076. doi: 10.1093/rap/rkad076Jansen N, Ten Klooster PM, Vonkeman HE, van den Berg B, Buitenweg JR. Further evaluation of inflammatory and noninflammatory aspects of pain in rheumatoid arthritis patients. Rheumatol Adv Pract. 2023;7(3):rkad076. doi: 10.1093/rap/rkad076Roodenrijs NMT, van der Goes MC, Welsing PMJ, Tekstra J, Lafeber FPJG, Jacobs JWG, et al. Difficult-to-treat rheumatoid arthritis: Contributing factors and burden of disease. Rheumatology (Oxford). 2021;60(8):3778-3788. doi: 10.1093/rheumatology/keaa860Roodenrijs NMT, van der Goes MC, Welsing PMJ, Tekstra J, Lafeber FPJG, Jacobs JWG, et al. Difficult-to-treat rheumatoid arthritis: Contributing factors and burden of disease. Rheumatology (Oxford). 2021;60(8):3778-3788. doi: 10.1093/rheumatology/keaa860Bertsias A, Flouri ID, Repa A, Avgoustidis N, Kalogiannaki E, Pitsigavdaki S, et al. Patterns of comorbidities differentially affect long-term functional evolution and disease activity in patients with ‘difficult to treat’ rheumatoid arthritis. RMD Open. 2024;10(1):e003808. doi: 10.1136/rmdopen-2023-003808Bertsias A, Flouri ID, Repa A, Avgoustidis N, Kalogiannaki E, Pitsigavdaki S, et al. Patterns of comorbidities differentially affect long-term functional evolution and disease activity in patients with ‘difficult to treat’ rheumatoid arthritis. RMD Open. 2024;10(1):e003808. doi: 10.1136/rmdopen-2023-003808Conran C, Kolfenbach J, Kuhn K, Striebich C, Moreland L. A review of difficult-to-treat rheumatoid arthritis: Definition, clinical presentation, and management. Curr Rheumatol Rep. 2023; 25(12):285-294. doi: 10.1007/s11926-023-01117-6Conran C, Kolfenbach J, Kuhn K, Striebich C, Moreland L. A review of difficult-to-treat rheumatoid arthritis: Definition, clinical presentation, and management. Curr Rheumatol Rep. 2023; 25(12):285-294. doi: 10.1007/s11926-023-01117-6Потапова АС, Каратеев АЕ, Полищук ЕЮ, Матьянова ЕВ, Паневин ТС, Семашко АС, и др. Особенности клинических проявлений ревматоидного артрита у пациентов с недостаточной эффективностью базисных противовоспалительных препаратов в зависимости от наличия признаков центральной сенситизации. Научно-практическая ревматология. 2023;61(2):214-219.Potapova AS, Karateev AE, Polishchuk EYu, Matyanova EV, Panevin TS, Semashko AS, et al. Features of clinical manifestations of rheumatoid arthritis in patients after failure of conventional synthetic disease-modifying antirheumatic drugs therapy depending on the signs of central sensitization. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2023;61(2): 214-219 (In Russ.). doi: 10.47360/1995-4484-2023-214-219Есин ОР, Горобец ЕА, Хайруллин ИХ, Есин РГ, Гамирова РГ, Шамсутдинова РФ, и др. Опросник центральной сенситизации – русскоязычная версия. Журнал неврологии и психиатрии им. С.С. Корсакова. 2020;120(6):51‑56.Esin OR, Gorobets EA, Khayrullin IKh, Esin RGm Gamirova RG, Shamsutdinova RF, et al. Central Sensitization Inventory – a Russian version. S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(6):51‑56. (In Russ.). doi: 10.17116/jnevro202012006151Данилов АБ, Давыдов ОС. Новые возможности диагностики нейропатической боли с помощью анкетных методов. Справочник поликлинического врача. 2008;5:40-44.Danilov AB, Davydov OS. New possibilities for the diagnosis of neuropathic pain using questionnaire methods. Spravochnik poliklinicheskogo vracha. 2008;5:40-44 (In Russ.).Freynhagen R, Baron R, Gockel U, Tolle T. PainDETECT: A new screening questionnaire to detect neropathic components in patients with back pain. Curr Med Res Opin. 2006;22:1911-1920.Freynhagen R, Baron R, Gockel U, Tolle T. PainDETECT: A new screening questionnaire to detect neropathic components in patients with back pain. Curr Med Res Opin. 2006;22:1911-1920.Rifbjerg-Madsen S, Christensen AW, Christensen R, Hetland ML, Bliddal H, Kristensen LE, et al. Pain and pain mechanisms in patients with inflammatory arthritis: A Danish nationwide crosssectional DANBIO registry survey. PLoS One. 2017;12(7):e0180014. doi: 10.1371/journal.pone.0180014Rifbjerg-Madsen S, Christensen AW, Christensen R, Hetland ML, Bliddal H, Kristensen LE, et al. Pain and pain mechanisms in patients with inflammatory arthritis: A Danish nationwide crosssectional DANBIO registry survey. PLoS One. 2017;12(7):e0180014. doi: 10.1371/journal.pone.0180014Tubach F, Ravaud P, Martin-Mola E, Awada H, Bellamy N, Bombardier C, et al. Minimum clinically important improvement and patient acceptable symptom state in pain and function in rheumatoid arthritis, ankylosing spondylitis, chronic back pain, hand osteoarthritis, and hip and knee osteoarthritis: Results from a prospective multinational study. Arthritis Care Res (Hoboken). 2012;64(11):1699-1707. doi: 10.1002/acr.21747Tubach F, Ravaud P, Martin-Mola E, Awada H, Bellamy N, Bombardier C, et al. Minimum clinically important improvement and patient acceptable symptom state in pain and function in rheumatoid arthritis, ankylosing spondylitis, chronic back pain, hand osteoarthritis, and hip and knee osteoarthritis: Results from a prospective multinational study. Arthritis Care Res (Hoboken). 2012;64(11):1699-1707. doi: 10.1002/acr.21747Heisler AC, Song J, Muhammad LN, Wohlfahrt A, Marder W, Bolster MB, et al. Association of dysregulated central pain processing and response to disease-modifying antirheumatic drug therapy in rheumatoid arthritis. Arthritis Rheumatol. 2020;72(12):2017-2024. doi: 10.1002/art.41440Heisler AC, Song J, Muhammad LN, Wohlfahrt A, Marder W, Bolster MB, et al. Association of dysregulated central pain processing and response to disease-modifying antirheumatic drug therapy in rheumatoid arthritis. Arthritis Rheumatol. 2020;72(12):2017-2024. doi: 10.1002/art.41440Ten Klooster PM, de Graaf N, Vonkeman HE. Association between pain phenotype and disease activity in rheumatoid arthritis patients: A non-interventional, longitudinal cohort study. Arthritis Res Ther. 2019;21(1):257. doi: 10.1186/s13075-019-2042-4Ten Klooster PM, de Graaf N, Vonkeman HE. Association between pain phenotype and disease activity in rheumatoid arthritis patients: A non-interventional, longitudinal cohort study. Arthritis Res Ther. 2019;21(1):257. doi: 10.1186/s13075-019-2042-4Saitou M, Noda K, Matsushita T, Ukichi T, Kurosaka D. Central sensitisation features are associated with neuropathic pain-like symptoms in patients with longstanding rheumatoid arthritis: A cross-sectional study using the central sensitisation inventory. Clin Exp Rheumatol. 2022;40(5):980-987. doi: 10.55563/clinexprheumatol/msy022Saitou M, Noda K, Matsushita T, Ukichi T, Kurosaka D. Central sensitisation features are associated with neuropathic pain-like symptoms in patients with longstanding rheumatoid arthritis: A cross-sectional study using the central sensitisation inventory. Clin Exp Rheumatol. 2022;40(5):980-987. doi: 10.55563/clinexprheumatol/msy022Adami G, Gerratana E, Atzeni F, Benini C, Vantaggiato E, Rotta D, et al. Is central sensitization an important determinant of functional disability in patients with chronic inflammatory arthritides? Ther Adv Musculoskelet Dis. 2021;13:1759720X21993252. doi: 10.1177/1759720X21993252Adami G, Gerratana E, Atzeni F, Benini C, Vantaggiato E, Rotta D, et al. Is central sensitization an important determinant of functional disability in patients with chronic inflammatory arthritides? Ther Adv Musculoskelet Dis. 2021;13:1759720X21993252. doi: 10.1177/1759720X21993252Guler MA, Celik OF, Ayhan FF. The important role of central sensitization in chronic musculoskeletal pain seen in different rheumatic diseases. Clin Rheumatol. 2020;39(1):269-274. doi: 10.1007/s10067-019-04749-1Guler MA, Celik OF, Ayhan FF. The important role of central sensitization in chronic musculoskeletal pain seen in different rheumatic diseases. Clin Rheumatol. 2020;39(1):269-274. doi: 10.1007/s10067-019-04749-1Noda K, Saitou M, Matsushita T, Ukichi T, Kurosaka D. How do central sensitisation features affect symptoms among patients with rheumatoid arthritis? Analysis of pain descriptors and the effect of central sensitivity syndrome on patient and evaluator global assessments. Clin Exp Rheumatol. 2022;40(11):2119-2124. doi: 10.55563/clinexprheumatol/nyxvyuNoda K, Saitou M, Matsushita T, Ukichi T, Kurosaka D. How do central sensitisation features affect symptoms among patients with rheumatoid arthritis? Analysis of pain descriptors and the effect of central sensitivity syndrome on patient and evaluator global assessments. Clin Exp Rheumatol. 2022;40(11):2119-2124. doi: 10.55563/clinexprheumatol/nyxvyuDougados M, Perrot S. Fibromyalgia and central sensitization in chronic inflammatory joint diseases. Joint Bone Spine. 2017;84(5):511-513. doi: 10.1016/j.jbspin.2017.03.001Dougados M, Perrot S. Fibromyalgia and central sensitization in chronic inflammatory joint diseases. Joint Bone Spine. 2017;84(5):511-513. doi: 10.1016/j.jbspin.2017.03.001Heiberg T, Kvien TK, Mowinckel P, Aletaha D, Smolen JS, Hagen KB. Identification of disease activity and health status cut-off points for the symptom state acceptable to patients with rheumatoid arthritis. Ann Rheum Dis. 2008;67(7):967-971. doi: 10.1136/ard.2007.077503Heiberg T, Kvien TK, Mowinckel P, Aletaha D, Smolen JS, Hagen KB. Identification of disease activity and health status cut-off points for the symptom state acceptable to patients with rheumatoid arthritis. Ann Rheum Dis. 2008;67(7):967-971. doi: 10.1136/ard.2007.077503Nowell WB, Gavigan K, Kannowski CL, Cai Z, Hunter T, Venkatachalam S, et al. Which patient-reported outcomes do rheumatology patients find important to track digitally? A real-world longitudinal study in ArthritisPower. Arthritis Res Ther. 2021;23(1):53. doi: 10.1186/s13075-021-02430-0Nowell WB, Gavigan K, Kannowski CL, Cai Z, Hunter T, Venkatachalam S, et al. Which patient-reported outcomes do rheumatology patients find important to track digitally? A real-world longitudinal study in ArthritisPower. Arthritis Res Ther. 2021;23(1):53. doi: 10.1186/s13075-021-02430-0Fautrel B, Alten R, Kirkham B, de la Torre I, Durand F, Barry J, et al. Call for action: How to improve use of patient-reported outcomes to guide clinical decision making in rheumatoid arthritis. Rheumatol Int. 2018;38(6):935-947. doi: 10.1007/s00296-018-4005-5Fautrel B, Alten R, Kirkham B, de la Torre I, Durand F, Barry J, et al. Call for action: How to improve use of patient-reported outcomes to guide clinical decision making in rheumatoid arthritis. Rheumatol Int. 2018;38(6):935-947. doi: 10.1007/s00296-018-4005-5Uhrenholt L, Christensen R, Dreyer L, Schlemmer A, Hauge EM, Krogh NS, et al. Using a novel smartphone application for capturing of patient-reported outcome measures among patients with inflammatory arthritis: A randomized, crossover, agreement study. Scand J Rheumatol. 2022;51(1):25-33. doi: 10.1080/03009742.2021.1907925Uhrenholt L, Christensen R, Dreyer L, Schlemmer A, Hauge EM, Krogh NS, et al. Using a novel smartphone application for capturing of patient-reported outcome measures among patients with inflammatory arthritis: A randomized, crossover, agreement study. Scand J Rheumatol. 2022;51(1):25-33. doi: 10.1080/03009742.2021.1907925

The authors declare that there are no conflicts of interest present.