The objective of this proposal is to determine the association between anti-CCP antibodies and pain in RA. Our central hypothesis is that the presence of anti-CCP antibodies is associated with high pain sensitivity and patient-reported pain, independent of inflammation, and that this relationship has a dose-response, with higher levels of antibodies being associated with greater pain sensitivity and pain intensity. We will test our central hypothesis via the following specific aims: 1: Identify the independent effect of anti-CCP antibody positivity/level on pain sensitivity assessed by quantitative sensory testing. We will determine the cross-sectional association between anti-CCP antibody status and pain sensitivity using existing data from 296 RA patients in the CPIRA cohort. We expect anti-CCP positive patients to have lower pain thresholds at RA-affected joints than anti-CCP negative patients, after adjustment for joint-specific inflammation (swollen joint count) and systemic inflammation (C-reactive protein (CRP) levels). Furthermore, we expect higher levels of anti-CCP to be associated with lower pain thresholds. 2: Identify the association between anti-CCP antibody positivity/level and patient-reported measures of pain. Using the same CPIRA dataset, we will assess the relationship between anti-CCP status and patientreported pain intensity and pain interference. We expect anti-CCP positive patients to report higher levels of pain intensity and pain interference, after adjustment for swollen joint count and CRP. We also expect higher levels of anti-CCP to be associated with greater patient-reported pain. Completion of the proposed project will elucidate the role of anti-CCP antibodies in the development of joint pain in RA patients. This project will also provide me with the opportunity to develop a project from conception to completion (including manuscript preparation and submission), learn principles of study design and analysis, and network with rheumatologists and clinical researchers within my institution and at other institutions. As a result, I will be well positioned to achieve my long-term goals of becoming a board-certified rheumatologist and independently-funded rheumatology researcher, with a focus on developing more effective management strategies for chronic pain in patients with systemic rheumatologic conditions.
|Effective start/end date||7/1/19 → 6/30/20|
- Rheumatology Research Foundation (Agmt 7/3/19)
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