{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:53:04Z","timestamp":1775091184455,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:00:00Z","timestamp":1704412800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to explore to what extent patients with axial spondyloarthritis (axSpA) link experienced pain in the neck, back, and hips to inflammation and\/or structural damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients from the Groningen Leeuwarden Axial Spondyloarthritis (GLAS) cohort visiting the outpatient clinic between 2016 and 2019 filled out two additional questions in relation to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) question 2: (1) \u201cTo what extent do you think the pain you experience in your neck, back, and hips is related to inflammation caused by axSpA?\u201d and (2) \u201cTo what extent do you think the pain you experience in your neck, back, and hips is related to damage of the spine and joints caused by axSpA?\u201d Answers had to be depicted on a numeric rating scale from 0 (none) to 10 (very much); a difference of \u22652 points between the scores of these questions was considered clinically relevant in favor of the highest scoring question.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 688 patients with axSpA (24% with nonradiographic axSpA [nr\u2010axSpA]) were included (62% male, mean \u00b1 SD age 48 \u00b1\u200914\u2009years, and mean \u00b1 SD Ankylosing Spondylitis Disease Activity Score [ASDAS] 2.3 \u00b1\u20091.0). Seventy\u2010five percent of patients could not link the origin of their pain, 15% linked axial pain predominantly to inflammation, and 10% linked axial pain predominantly to damage. Patients in the inflammation group were younger, had shorter symptom duration, were more frequently diagnosed with nr\u2010axSpA, had higher ASDAS<jats:sub>CRP<\/jats:sub>, had more often elevated CRP levels, had fewer comorbidities, had better spinal mobility, and had less spinal radiographic damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our large observational cohort, the majority of patients with axSpA could not differentiate the origin of experienced axial pain. If patients were able to link axial pain to clinical inflammation or damage, it was in concordance with clinical assessments and radiographic outcome, which may be helpful in establishing the origin of pain and supporting better patient\u2010centered treatment decisions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25246","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T04:19:32Z","timestamp":1696220372000},"page":"350-358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Patients\u2019 Perspectives on Axial Pain in Relation to Inflammation and Structural Damage in a Large Cohort of Axial Spondyloarthritis Patients"],"prefix":"10.1002","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6844-018X","authenticated-orcid":false,"given":"Anne","family":"Kampman","sequence":"first","affiliation":[{"name":"Medical Center Leeuwarden  Leeuwarden The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freke","family":"Wink","sequence":"additional","affiliation":[{"name":"Medical Center Leeuwarden, Leeuwarden, and University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davy","family":"Paap","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen, Groningen, and Saxion University of Applied Sciences  Enschede The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9234-0608","authenticated-orcid":false,"given":"Marlies","family":"Carbo","sequence":"additional","affiliation":[{"name":"University of Groningen, University Medical Center Groningen  Groningen The 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