A cross-sectional study illustrated a positive association between disease activity indexes and the occurrence of neuropathic pain in axial spondyloarthritis (axSpA)-affected people undergoing biologic therapy. Researchers sought to assess the link between the presence of neuropathic pain, disease activity scores, and choices to switch biologic drugs.

People with axSpA aged ≥18 years and undergoing biologic therapy for a minimum of 6 months were evaluated for neuropathic pain using the PainDETECT Questionnaire. Analysis was done on the connections between the presence of neuropathic pain, disease activity scores, inflammatory indicators, life quality index, and biologic medication switching decisions. A total of 175 individuals with axSpA were involved in the trial, including 25 with non-radiographic axSpA (nr-axSpA) and 150 with ankylosing spondylitis.

Neuropathic pain was common in axSpA-patients treated with multiple biologic agents. This pain was found in 41.7% of the subjects, with female patients having a higher prevalence than male patients. Scores from PainDETECT were strongly linked with disease activity scores but not with levels of inflammatory markers. After the biologics had been replaced three times or more, neuropathic pain was substantially more prevalent. Among patients for whom medication-switching choices had been made because of primary or secondary nonresponsiveness, PainDETECT scores were higher and neuropathic pain was more common.

The prevalence of neuropathic pain in individuals with axSpA is higher than anticipated, and the existing disease activity scores are not sufficient to distinguish between inflammatory pain and neuropathic pain. For the assessment of therapeutic response to biologics, neuropathic pain is a confounding factor. Prior to making decisions to switch biologic drugs in persons with ankylosing spondylitis and nr-axSpA who are refractory to their primary or secondary treatments, neuropathic pain presence must be taken into account.