Fatigue and associated factors in a multi‐ethnic cohort of rheumatoid arthritis patients

Abstract

Introduction: Fatigue is an important yet infrequently evaluated component in patients with rheumatoid arthritis (RA) and may have a major impact on quality of life. Objectives: To evaluate fatigue, identify factors associated with fatigue and assess the effect of fatigue on health-related quality of life (HRQoL) in a multi-ethnic cohort of RA patients. Methods: A cross-sectional study was performed in patients who fulfilled European League Against Rheumatism/ American College of Rheumatology 2010 criteria for RA. Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire was used to assess fatigue. Potential factors for fatigue were categorized into RA-related (gender, seropositivity [rheumatoid factor and/or anti-citrullinated protein antibody], disease duration, visual analog scale pain score, Disease Activity Score of 28 joints-erythrocyte sedimentation rate [DAS28-ESR], ESR, hemoglobin level, functional disability [Health Assessment Questionnaire-Disability Index, HAQ-DI score], EQ-5D-3L, concomitant prednisolone use and number of conventional synthetic disease-modifying anti-rheumatic drugs [csDMARDs] used) and non-RA-related (age, body mass index, ethnicity and number of co-morbidities). Results: A total of 214 patients (86.9% female) were included; the median age was 62 (25-91) years and 67.3% were seropositive. Seventy-six (33.5%) patients had moderate disease activity, 12 (5.6%) had high disease activity and 152 (71%) patients had mild difficulties to moderate disability HAQ-DI scores. Median of total FACIT-F score was 113.2 (36.3-160.0). Joint factors of younger age, longer disease duration, higher HAQ score (increased functional disability), and lower EQ-5D (poorer HRQoL) were significantly associated with higher levels of fatigue (all P < .02). Conclusion: Fatigue was associated with functional disability and has a significant impact on HRQoL in RA. Fatigue assessment should be considered in routine clinical practice for RA patients.

The Link between the Demographic and Clinical Factors and Fatigue Symptoms among Rheumatoid Arthritis Patients

“…Madsen et al [ 29 ], Lao et al [ 16 ], Bingham et al [ 30 ], Abdel-Magied et al [ 17 ], Olsen et al [ 27 ], Holdren et al [ 31 ], and Bączyk and co-authors [ 24 ], confirming that increased pain and its changing nature increased fatigue levels. Lee et al [ 22 ], Hammam et al [ 15 ], and Wagan et al [ 18 ] analyzed the influence of hemoglobin concentration on fatigue; their studies did not show a relationship between the variables, in contrast to the results of our studies. On the other hand, the influence of low hemoglobin values on fatigue was confirmed by Madsen et al [ 29 ], van Steenbergen et al [ 25 ], and Olsen et al [ 27 ].…”

“…Uhlig and Provan [ 19 ], Feldthusen et al [ 20 ], and Katz et al [ 21 ] also indicated that factors such as age and gender were not significantly associated with fatigue. Different results can be seen in the studies by Lee et al [ 22 ] and Diniz et al [ 23 ]. These studies showed that younger age is significantly associated with higher fatigue values, but gender is not.…”

“…The influence of disease activity on the deterioration of fatigue results was also observed by Hammam et al [ 15 ], Diniz et al [ 23 ], Abdel-Magied et al [ 17 ], Madsen et al [ 29 ], Lao et al [ 16 ], Bingham et al [ 30 ], Holdren et al [ 31 ], and Wagan et al [ 18 ]. Different results, indicating no relationship between disease activity and the level of fatigue, were obtained by Feldthusen et al [ 20 ], Lee et al [ 22 ], Rodriguez-Muguruza et al [ 26 ]. Madsen et al [ 29 ], Lao et al [ 16 ], Bingham et al [ 30 ], Abdel-Magied et al [ 17 ], Olsen et al [ 27 ], Holdren et al [ 31 ], and Bączyk and co-authors [ 24 ], confirming that increased pain and its changing nature increased fatigue levels.…”

The effect of physical exercise on rheumatoid arthritis: An overview of systematic reviews and meta‐analysis

“…Fatigue, arthritis, and deformity are the main complications of RA, which lead to the impairment of body function (Englbrecht et al, 2013). Studies from different countries and regions show that fatigue is highly prevalent in patients with RA (40%-80%) (Lee et al, 2020). The most common symptom is pain (Borenstein et al, 2010), which has a negative impact on body function and quality of life (Boyden et al, 2016).…”

Outcome after resection arthroplasty or shortening oblique osteotomy of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal joint for severe rheumatoid forefoot deformities

“…34 Furthermore, higher HAQ-DI score (>1.0) indicates the patient has moderate to severe functional disabilities and could predict worse outcomes. 35,36 Both procedures in our study were performed in older adults with relatively low ADL. It is reasonable to presume that toe arthroplasty alone resulted in only limited improvement in SAFE-Q subscale scores.…”