Fatigue in systemic lupus erythematosus and other autoimmune skin diseases

Abstract

Summary Background Fatigue is a well‐established symptom in systemic lupus erythematosus (SLE), but has not been well characterized in other skin‐limited autoimmune diseases such as cutaneous lupus erythematosus (CLE), amyopathic dermatomyositis (ADM) or autoimmune blistering diseases (AIBD). Objectives In this retrospective study, we compared fatigue in controls (n = 84) with that in patients enrolled in prospective longitudinal databases with SLE (n = 165), CLE (n = 226), ADM (n = 136) and AIBD (n = 79). Methods We used the 36‐Item Short Form Survey (SF‐36) vitality scale to analyse median scores and the percentages of patients with clinically significant fatigue (defined as a score ≤ 35) between experimental groups and controls. Results Median and interquartile range (IQR) vitality scores demonstrated greater fatigue in the experimental groups (SLE 35, IQR 20–55; CLE 50, IQR 30–70; ADM 50, IQR 30–65; AIBD 55, IQR 35–70) than in controls (73, IQR 65–85) (P < 0·05 for each experimental group vs. control). The SLE group had worse fatigue than all of the other groups (P < 0·05 SLE vs. each group), but there was no difference between the CLE, ADM or AIBD groups (all P > 0·05). In addition, the experimental groups had more clinically significant fatigue (score ≤ 35) (SLE 44·2%, CLE 25·2%, ADM 31·6%, AIBD 24·1%) than controls (2%) (P < 0·01 for each experimental group vs. control). The SLE group had more clinically significant fatigue than the CLE group (P < 0·01); however, there was no difference in clinically significant fatigue between SLE and either ADM (P = 0·17) or AIBD (P = 0·055). Conclusions These findings demonstrate that patients with skin‐limited autoimmune disease experience more fatigue than controls. Fatigue is an important symptom that negatively affects quality of life for patients. It should be addressed by clinicians and measured in future clinical trials.

Factors associated with quality of life in cutaneous lupus erythematosus using the Revised Wilson and Cleary Model

“…reported that patients with autoimmune conditions experience higher fatigue levels than controls. 45 Furthermore, the study showed that patients with SLE had worse fatigue scores than CLE patients. Given that more than half of the respondents in our current study had a concomitant diagnosis of SLE, it could explain why fatigue was a significant predictor of QoL.…”

Ocular surface disorders affect quality of life in patients with autoimmune blistering skin diseases: a cross-sectional study

“…The SF-36 is widely used to evaluate health-related quality of life, especially in cancer [ 31 ], chronic diseases [ 32 , 33 ] and postoperative evaluation [ 34 ]. As a chronic disease, the SF-36 was also administered to patients with AIBD to evaluate their quality of life, particularly their psychological profile and fatigue [ 35 , 36 ]. There were also statistically significant differences in HADS scores between AIBD and non-AIBD volunteers.…”

The current status and associated factors of fatigue in Chinese patients with gout: A cross-sectional study

“…In addition, more than half of participants have tophi (51%) and comorbidities (52.4%), it suggests a severe disease burden. Among the gout participants, more than half of gout patients(64.9%) are in the acute stage, the median (IQR) of disease duration were 5 (2,12)…”

“…Fatigue, which is an important component of health-related quality of life, is only rarely assessed and remains poorly understood. As a health problem, fatigue is a prevalent phenomenon among many patients with chronic, metabolic, rheumatic, inflammatory arthritis diseases, such as chronic obstructive pulmonary disease, diabetes, rheumatoid arthritis, systemic lupus erythematosus and osteoarthritis (11)(12)(13)(14). While fatigue is usually regarded as a fairly somatic phenomenon, they often report fatigue as one of their most debilitating symptoms (15).…”