Furthering Our Understanding of Fatigue in Rheumatoid Arthritis

Hewlett, Sarah; Choy, Ernest; Kirwan, John R.

doi:10.3899/jrheum.120724

Cited by 20 publications

(18 citation statements)

References 16 publications

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“…In vasculitis, 48% of patients with microscopic polyangitis have been reported to complain of muscle pain [ 114 ], while different cases of myalgia as initial symptom of polyarteritis nodosa [ 115 ] or of ANCA-associated vasculitis [ 116 ] have been described. Moreover, malaise or fatigue are reported in about 30% of patients with polymyalgia rheumatica [ 107 ] and 42–69% of people with rheumatoid arthritis [ 117 ]. In an international survey including over 6000 participants [ 118 ], patients with rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, Sjögren’s syndrome, psoriatic arthritis, or systemic sclerosis, presented severe fatigue in 41 to 57% of cases.…”

Section: Discussionmentioning

confidence: 99%

Rheumatic manifestations of COVID-19: a systematic review and meta-analysis

et al. 2020

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Background Different proportions of musculoskeletal or autoimmune manifestations associated with COVID-19 have been reported in literature. We performed a systematic review and meta-analysis with the aim of assessing the prevalence of rheumatic manifestations in patients affected by COVID-19, as initial symptom or during disease course. Methods A database search was run on May 18th, 2020, using two distinct strategies. We were interested in the percentage of symptoms of potential rheumatologic interest observed in large population studies of COVID-19 cases, and in identifying uncommon autoimmune disorders described in patients with COVID-19. For manifestations individually reported, a meta-analysis was performed taking into consideration the proportion of COVID-19 patients presenting the symptom. Results Eighty eight original articles were included in the systematic review and 51 in the meta-analysis. We found pooled estimates of 19% for muscle pain and 32% for fatigue as initial symptom of COVID-19 presentation and, respectively, of 16 and 36% during the disease course. Only one article discussed arthralgia as unique symptom. Additionally, we found that vasculitis, chilblains, presence of autoantibodies commonly found in patients with rheumatic diseases, or autoimmune haematological and neurological disorders have all been reported in patients with COVID-19. Conclusions In conclusion, our review and meta-analysis emphasises that symptoms potentially leading to rheumatologic referral are common in patients with COVID-19. Therefore, COVID-19 is a new differential diagnosis to bear in mind when evaluating patients with musculoskeletal symptoms and rheumatologists might play a crucial role in identifying COVID-19 cases in early phases of the illness.

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Section: Discussionmentioning

confidence: 99%

Rheumatic manifestations of COVID-19: a systematic review and meta-analysis

et al. 2020

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“…Awareness of the importance of fatigue in inflammatory conditions has grown over the past decade [ 20 ]. Whilst patients report fatigue as one of the key symptoms of their condition, there is limited evidence of an improved understanding of fatigue in axSpA and its impact on patients’ lives [ 3 , 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…A growing number of multi-item fatigue-specific (for example, the Multidimensional Fatigue Inventory (MFI-20) [ 17 ] and Fatigue Severity Scale [ 18 ]) and condition-fatigue-specific (for example, the BRAF-MDQ [ 12 ] and Functional Assessment of Cancer Therapy scale [ 19 ]) PROMs are now available. This growth in availability reflects the importance of capturing the multi-faceted, often condition-specific, nature of fatigue [ 20 ] and the importance of seeking to reflect the outcomes that really matter to patients [ 21 ]. However, it is unclear how well these measures perform in the axSpA population; it cannot be assumed that the measurement and practical properties of measures are consistent across different patient populations.…”

Section: Introductionmentioning

confidence: 99%

Quality and acceptability of patient-reported outcome measures used to assess fatigue in axial spondyloarthritis (axSpA): a systematic review (protocol)

et al. 2018

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BackgroundThe prevalence of axial spondyloarthritis (axSpA) is estimated between 0.15 and 1.2%, with many of those patients experiencing severe fatigue. Current axSpA assessment guidance recommends use of a single-item visual analogue scale for fatigue severity. However, concerns have been raised about the ability of such a limited assessment to identify patients with major fatigue, to detect important change in fatigue or to reflect the multi-dimensional nature of fatigue. The proposed systematic review will identify and evaluate the quality and acceptability of single- and multi-item patient-reported outcome measures (PROMs) used to assess fatigue in axSpA, seeking to make recommendations for the ‘best’ measures for research and/or clinical practice.Methods/designThe review will seek to include published studies which report evidence of the development and/or measurement and/or practical properties of clearly defined and reproducible measures of fatigue following completion by patients with axSpA. Five major databases will be searched from 1980 to August 2017: MEDLINE (OVID), EMBASE (OVID), PsycINFO (OVID), World of Science and CINAHL. Study methodological quality will be assessed against the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. The measurement and/or practical properties of reviewed measures will be assessed against current international standards. A short list of the ‘best’-quality PROMs will be produced. The review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.DiscussionThis study will provide the first robust and transparent evaluation of patient-reported measures of fatigue used in the axSpA population, synthesising evidence of quality, relevance and acceptability. The review will benefit patients, clinicians, health professionals and researchers wishing to enhance axSpA-fatigue assessment in routine practice, service evaluation and research. The findings will impact future research which seeks to better understand the nature of axSpA fatigue and evaluate the relative benefit of fatigue-management strategies.Systematic review registrationPROSPERO CRD42016042271Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0777-7) contains supplementary material, which is available to authorized users.

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“…Age, gender and social habits such as smoking, general symptoms such as malaise, weight loss, mild fevers and night sweats should be considered (Oliver and Silman 2006), In addition, patients may commonly report fatigue (Hewlett et al 2012) and depression (Palkonyai et al 2007) early on in the disease (Lempp et al 2011).…”

Section: Historymentioning

confidence: 99%