Correlations of fatigue in Danish patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis

Abstract

Objective To describe fatigue in relation to disease-specific and socioeconomic factors and to test possible correlations between fatigue and work impairment, quality of life, pain, sleep, depression, and physical functioning in people with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). Methods A questionnaire-based cross-sectional survey collecting patient characteristics such as disease characteristics, socioeconomic factors and patient-reported outcomes (PROs) from patients with RA, PsA and axSpA in Denmark. PRO scales included the FACIT-Fatigue sub-scale, Work Productivity and Activity Impairment scale (WPAI), EuroQol (EQ-5D), Medical Outcomes Study Sleep Scale (MOS), Major Depression Inventory (MDI), and Health Assessment Questionnaire (HAQ). Respondents were recruited via routine visits to the outpatient rheumatology clinic; information on diagnosis, treatment and disease activity was collected from medical journals by trained nurses. Results 487 patients participated in the study. Fatigue was more present in women, experienced patients, and patients who changed medication in the past 12 months, who were unemployed, who had less education, and who had lower household income. There was no statistically significant difference between mean fatigue in the three diagnostic groups (p = 0.08). Fatigue correlated with all included PROs (Pearson correlation coefficients, p<0.0001). Stratifying for diagnosis and adjusting for socioeconomic factors did not change the conclusion.

Fatigue in early rheumatoid arthritis: data from the Early Rheumatoid Arthritis Network

“…We identified that female sex, pain, mental health and functional ability showed a consistent association with fatigue when examined cross-sectionally and predicted people more likely to belong to the Fatigue group. This concurs with findings from another study [ 32 ] and is mirrored in people with inflammatory and non-inflammatory diseases, including post-viral fatigue and post-chemotherapy fatigue [ 33 , 34 ]. Interestingly, many RA-related characteristics such as inflammation and duration of disease were not consistently significantly associated with fatigue cross-sectionally and longitudinally in our analyses [ 35 ].…”

Work productivity and activity in patients with SAPHO syndrome: a cross-sectional observational study

“…Fatigue, sleep disturbance, psychological distress, and poor physical function are common problems among patients with SAPHO syndrome, and these symptoms can significantly influence the quality of life of patients and cause loss of work productivity. Similar results were observed in rheumatoid arthritis, psoriatic arthritis, spondyloarthropathies, systemic lupus erythematosus, and insomnia [ 28 – 30 ]. When regarding the association between autoimmune disorders and WPAI, the study of White D. demonstrated a significant reduction in the quality of life and work productivity in patients with ankylosing spondylitis [ 31 ].…”

Fatigue in multiple sclerosis is associated with socioeconomic factors

“…Fatigue is also a prevalent symptom in several other autoimmune diseases (Zielinski et al, 2019), and having more autoimmune comorbidities seem to increase the fatigue severity. In a Danish study, the researchers evaluated fatigue in relation to disease-specific and socioeconomic factors in patients with rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis (Esbensen et al, 2020). They found that fatigue was more prevalent in women, in "experienced patients", in patients who had changed medication in the past 12 months, were unemployed, had less education, and had lower household income.…”