Reporting of patient-perceived impact of rheumatoid arthritis and axial spondyloarthritis over 10 years: a systematic literature review

Abstract

Objective. RA and axial SpA have an important impact on patients’ lives. The objective of this study was to explore the reporting of different aspects of that impact in publications, with a focus on differences between diseases and over time.Methods. A systematic literature review retrieved all articles reporting on the life impact of RA or axial radiographic SpA in adults published within the last 10 years and issued from European research. The data were classified into physical impact (including pain, functional assessment and fatigue), psychological impact (including psychological distress and coping) and social impact (including relationships, family and social life). The number of articles published over time was analysed by linear regression.Results. In all, 1352 abstracts were screened and 149 publications (40 056 patients) were analysed: 129 articles (86.5%) concerned RA and 16 (10.7%) concerned axial SpA. The mean number of articles reporting on the physical aspects of impact was 11.4 (s.d. 4.8) per 2-year period, but increased more than 2-fold (from 7 articles in 2001–3 to 15 in 2010–11), in particular due to recent publications on fatigue, whereas the number of articles on psychological aspects [mean 12.4 (s.d. 4.0)] decreased markedly after 2006. Publications reporting on social aspects [mean 8.2 (s.d. 4.1)] remained globally stable.Conclusion. In the era of biologics, there is an interest in the patient-perceived life impact of RA and axial SpA in the European literature, but the impact of RA has been the subject of greater exploration. There are clearly trends over time in the reporting of impact.

Fatigue in early axial spondyloarthritis. Results from the French DESIR cohort

“…In the present cohort, use of anti-TNF therapies was low over the first year of follow-up, and was not specifically analysed here. The high levels of fatigue seen in axSpA and potential consequence of fatigue, are offset by few publications on this subject: a systematic literature review evidenced only 3 papers on fatigue in SpA over a 10-year period in Europe, versus 16 papers in RA over the same period [22].…”

Fatigue in chronic inflammation - a link to pain pathways

“…Unusual and chronic fatigue with various etiologies was described for 27 % of patients in a primary care clinic [ 31 ]. Fatigue is common in RA, SpA, Sjögren syndrome, systemic lupus erythematosus and vasculitis, although most publications concerned fatigue in RA or SpA [ 9 , 14 , 32 – 35 ]. In RA and SpA, the frequency of fatigue ranged from 42 % to 80 % depending on the definition and methods of assessment [ 1 , 4 , 8 , 36 – 39 ].…”

La fatigue au cours de la spondyloarthrite axiale débutante. Résultats de la cohorte française DESIR

“…Dans la cohorte actuelle, l'utilisation de thérapies anti-TNF concernait une minorité de patients au cours de la première année de suivi, et n'a pas été spécifiquement analysée ici. Les niveaux de fatigue élevés observés dans l'axSpA et les conséquences potentielles de cette fatigue sont étayés par peu de publications sur ce sujet : une revue systématique de la littérature indique seulement 3 articles sur la fatigue dans la SpA sur une période de 10 ans en Europe, contre 16 papiers dans la PR pour la même période [22]. M a n u s c r i p t 10 Dans cette étude, la fatigue était étroitement liée à l'activité de la maladie plutôt qu'à des variables liées au patient.…”