News in brief: Patients with AS and nr-axSpA have similar pain burden; Patient perspective on gout flares; One in four patients wait too long for essential procedures


Patients with AS and nr-axSpA have similar pain burden

New research has shown that patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-axSpA) have similar pain burden.

For the study, published in The Journal of Rheumatology, the research team look at data from patients with axial SpA (axSpA) enrolled in the population-based SPARTAKUS cohort and classified as AS (n=120) or nr-axSpA (n= 55). They then assessed pain (intensity/duration/distribution) and pain sensitivity (threshold/tolerance/temporal summation of pain) in participants.

The results showed that of 175 patients with axSpA, 43% reported experiencing chronic widespread pain, and that there were no significant differences between patients with AS and nr-axSpA.

According to the paper, lower pain tolerance was linked with longer symptom duration, worse ratings on disease activity score and function, more pain regions, unacceptable pain, fatigue, anxiety and health-related quality of life. 

The study shows that chronic pain is common in axSpA and that there were no observed differences in any pain measures between patients with AS and nr-axSpA. Also, higher pain sensitivity-linked with having worse disease and health outcomes. 

“The results indicate that patients with AS and nr-axSpA, in line with most clinical characteristics, have a similar pain burden, and they highlight large unmet needs regarding individualized pain management, regardless of axSpA subgroup,” they said.


Patient perspective on gout flare priorities

Activity limitation and pain during their worst gout flares contribute the most to the burden of disease in people with gout.

A New Zealand-led study of 50 patients asked participants to rate the most and least important attributes of gout flares over a hypothetical six-month period.

“Difficulty doing usual activities during the worst flare and pain of the worst flare were ranked as the most important, while average pain of all flares was considered the least important.”

“Overall, attributes related to the single worst gout flare were considered more important than attributes related to the cumulative impact of all flares.”

Read more in The Journal of Rheumatology


One in four patients wait too long for essential procedures: AMA Report Card

The AMA’s latest hospital report card shows that nationally only 75% of patients classified as Category 2 for elective surgery received treatment within the recommended timeframe.

Federal AMA President, Dr Omar Khorshid said the hospital system was already overwhelmed before the COVID-19 pandemic hit in 2020, due to an relentless decline in the number of beds available per head of population.

“While called ‘elective’ surgery, this really is essential surgery that includes serious conditions like heart valve replacements and cancer investigations,” he said.

“In reality, what this means is that 25% of people will wait longer than 90 days for surgeries, which in this category can include treatment for an unruptured brain aneurism, decompression of a spinal cord and treatment for ovarian cysts or unhealed fractures.

Dr Khorshid said the problem was particularly bad for patients in states such as Tasmania where more than a 63% are waiting longer than the recommended period for essential surgery.

The report card showed that the ratio of beds available for people over the age of 65 (the most intensive users of public hospital beds) has been on a downward trend for 27 years, halving from 33 to just over 15 per 1000 people.

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