CLINICAL FEATURES OF RHEUMATOID ARTHRITIS UNDER THE CONDITIONS OF COMORBIDITY WITH ALEXITHYMIA

Shalkovskyi E.I.¹, Kuzminova N.V.¹, Ostapchuk O.I.², Stanislavchuk M.A.³

• ¹National Pirogov Memorial Medical University, Vinnytsya
• ²National Pirogov Memorial Medical University, Vinnytsya
• ³National Pirogov Memorial Medical University, Vinnytsia

Summary. Introduction. Alexithymia is an important factor influencing the clinical course and prognosis of RA. Aim: to study the features of the clinical manifestations of RA in the presence of alexithymia, and to evaluate the relationship between the clinical manifestations of RA and the manifestations of alexithymia. Materials and methods. 146 RA patients were clinically examined using the DAS-28, SDAI, CDAI, VAS, HAQ, DRI and TAS-20 indices. Results. The prevalence of alexithymia in patients with RA was 24.6% (25.0% in women, 23.3% in men, p>0.05). Patients with alexithymia were characterized by a longer duration of the disease: 9.9±4.8 years versus 6.6±4.4 years in patients without alexithymia (p<0.001), which may indicate the formation of alexithymic traits in the dynamics of the disease. It was found that patients with alexithymia have more severe stages of RA: stage III (41.7%) and stage II (38.9%), while among patients without alexithymia, patients with stage II (46.4%) and stage I prevailed (40.0%). It was established that patients with alexithymia are characterized by higher RA activity: ESR — 29.47±14.38 mm/h versus 20.43±13.95 mm/h (p<0.001), DAS-28 — 6.35±0, 65 points versus 5.19±1.14 points (p<0.001), SDAI — 39.14±8.50 points versus 29.06±11.59 points (p<0.001), CDAI — 37.53±8, 75 points versus 28.20±11.47 points (p<0.001), a more pronounced pain syndrome according to VAS according to the patient’s assessment — 7.64±0.89 points versus 5.70±1.40 points (p<0.001), and doctor — 6.92±0.87 points against 5.23±1.32 points (p<0.001), worse functional ability according to HAQ — 1.67±0.57 points against 0.92±059 points (p<0.0001), the higher value of the DRI index — 44.5±16.85 points versus 26.77±14.76 points (p<0.001). Correlation analysis revealed the presence of significant direct correlations of a moderate and weak degree between TAS-20 indicators and the duration of RA disease, its activity according to DAS-28, SDAI and CDAI, expressiveness of pain syndrome according to VAS, functional ability according to HAQ, as well as with DRI index. Conclusions. Alexithymia is present in 26.4% of patients with RA and is associated with longer disease duration, worse indicators of the clinical course of RA, and may be a predictor of high activity, rapid progression to more severe radiological stages, and loss of work capacity.