Pain in Biologic-Treated Rheumatoid Arthritis Patients: The Role of Illness Perception Before and After the COVID-19 Pandemic

Background: We aimed to assess the role of the COVID-19 pandemic in the association of clinical, physical, and psychological factors with pain in Rheumatoid Arthritis (RA) patients.

Methods: We included 103 RA patients (81.6% females; mean age 56.1 ± 13.8 years). Patients filled out the VAS-pain, GAD-7, PHQ-9, MFI-20, and B-IPQ. Paired sample t-tests, correlations, and multiple regression analyses were used to analyse the data.

Results: Our results showed significantly worsened pain in the data collected post-pandemic (p ≤ 0.05). Pre-pandemic, the final regression models showed an association between functional disability (β = 0.24; p ≤ 0.05), illness perception (β = 0.34; p ≤ 0.05) and pain. In post-pandemic models, significant associations were found between fatigue (β = 0.33; p ≤ 0.01) and illness perception (β = 0.36; p ≤ 0.01) with pain. Positive illness perception was able to alleviate the associations between fatigue and depression with pain before and after the pandemic.

Conclusion: Findings indicate that patients with RA may have been negatively affected by the COVID-19 pandemic given their vulnerability. Even though pharmacological treatment was not interrupted, post-pandemic results showed significantly higher levels of experienced pain. Therefore, in addition to biological therapy, non-pharmacological interventions, including psychological support aimed at diminishing negative illness perception, may be beneficial in reducing RA-related pain, especially when dealing with a crisis.