Ab1413 assessment of Fatigue in Young Adults With Juvenile Idiopathic Arthritis

Abstract

BackgroundFatigue is a common and frustrating symptom in many chronic inflammatory diseases, including juvenile idiopathic arthritis (JIA), impacting all parts of daily life.ObjectivesThis study aims to determine the prevalence of fatigue in young patients with JIA and to analyze its correlation with clinical characteristics of the disease, body mineral content (BMC), and bone mass density (BMD).MethodsCross-sectional study included young adults with JIA according to ILAR criteria, disease duration ≥3 years. Exclusion criteria: age<18 and >44 years, the presence of any comorbidity that could be accompanied by fatigue (diabetes, chronic kidney disease, neuropathy, obesity, chronic obstructive pulmonary disease, infections, malignancy). Demographic data and the following clinical parameters were collected: pain Visual Analog Scale (VAS) measured by patients and doctors, tender joint count (TJC), swollen joint count (SJC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Disease Activity Score 28 (DAS28), Juvenile Arthritis Disease Activity Score (JADAS27), health assessment questionnaire (HAQ), Juvenile Arthritis Damage Index-articular (JADI-A) and Juvenile Arthritis Damage Index-extra-articular (JADI-E). BMC and BMD were determined using dual photon X-ray absorptiometry (DXA). Fatigue was assessed using the Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F) short 13-item questionnaire validated in RA. Fatigue was considered mild if the FACIT-F score was ≥40, moderate if 20≤FACIT-F<40, and severe if 0≤FACIT-F<20. A p-value lower than 0.05 was considered significant.ResultsWe included 40 patients with JIA (24 women and 16 men) with a mean age of 24.4±5. The mean disease duration was 13,8±8,1 years. The mean pain VAS measured by the patient was 38,8±3,4; the mean pain VAS measured by the doctor was 33,6±4,1; the mean TJC and SJC were 4,2±4,9 and 1,9±3,2, respectively. The mean levels of ESR and CRP were 20,2±2,7 mm/h and 26,1±7,0 mg/l, respectively. The mean DAS28-ESR was 3,6±1,5, the mean JADAS27 was 13,3±8,7, and the mean HAQ score was 0.60±0.6. The mean FACIT-F score was 30.1±12.4. Fatigue was mild in 37.5% (15 patients), moderate in 35% (14 patients), and severe in 27.5% (11) of patients. A significant negative correlation was noted between the FACIT-F score and the following parameters in JIA patients: disease duration (r=-0.436, p<0.001), articular and extra-articular damage obtained by JADI-A and JADI-E indices (r=-0.393, p=0.01, r=-0.440, p=0.05, respectively), pain VAS obtained by a doctor (r=-0.358, p=0.02), but not with pain VAS obtained by the patient (r=-0.167, p=0.3), ESR (r=-0.503, p<0.001), but not with CRP (r=-0.157, p=0.3), DAS28-ESR (r=-0.414, p<0.05), JADAS27 (r=-0.391, p<0.01) but not with TJC (r=-0.080, p=0.8), and SJC (r=-0.239, p=0.2). FACIT-F score was positively associated with total BMD (r=0.364, p=0.2), femoral neck BMD (r=0.519, p=0.007), appendicular lean mass (r=0.666, p<0.001), total lean mass (r=0.622, p<0.001), and skeletal mass index (r=0.703, p<0.001), but not with HAQ (r=0.035, p=0.8).ConclusionIn our study, moderate and severe fatigue among young patients with JIA was 35% and 27.5%, respectively. The fatigue was associated with disease activity, duration of disease, articular and extra-articular damage, total and femoral neck BMD, and lean mass.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.