Severity of fatigue in people with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis – Results of a cross-sectional study

Pilgaard, Trine; Hagelund, Lise; Stallknecht, Sandra Elkjær; Jensen, Henrik; Esbensen, Bente Appel

doi:10.1371/journal.pone.0218831

Cited by 27 publications

(21 citation statements)

References 35 publications

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“…Our results showed 21.2% prevalence of severe fatigue, consistent with previous studies 20 . This was also consistent across different fatigue assessment methods, cultures and ethnicities 5,18‐20 . Based on the above findings, fatigue phenomenon in PsA should not be neglected and under‐estimated.…”

Section: Discussionsupporting

confidence: 92%

“…Recently, Pilgaard et al found that severe fatigue was extremely common not only in PsA (approximately 27%), but also across rheumatoid arthritis (RA) (approximately 25%) and axial spondyloarthropathy (axSpA) (approximately 28%), from the Danish National Rheumatology Registry (DANBIO) 20 . Our results showed 21.2% prevalence of severe fatigue, consistent with previous studies 20 . This was also consistent across different fatigue assessment methods, cultures and ethnicities 5,18‐20 .…”

Section: Discussionsupporting

confidence: 90%

“…In 2016, Tobin et al reported that about 40% of PsA patients had fatigue, based on the VAS 19 . Recently, Pilgaard et al found that severe fatigue was extremely common not only in PsA (approximately 27%), but also across rheumatoid arthritis (RA) (approximately 25%) and axial spondyloarthropathy (axSpA) (approximately 28%), from the Danish National Rheumatology Registry (DANBIO) 20 . Our results showed 21.2% prevalence of severe fatigue, consistent with previous studies 20 .…”

Section: Discussionmentioning

confidence: 99%

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Fatigue in psoriatic arthritis: Is it related to disease activity?

Lai

Chung

et al. 2021

Int J of Rheum Dis

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Aim Fatigue is commonly associated with psoriatic arthritis (PsA). However, information about its prevalence and associated factors is sparse. The primary objective here was to find the prevalence and magnitude of PsA fatigue. The secondary objective was to explore its associated risk factors, particularly emphasis on the effect of disease activity control. Methods PsA patients who fulfilled Classification Criteria For Psoriatic Arthritis were consecutively recruited from local rheumatology clinics. Fatigue was assessed by a 13‐item self‐administered questionnaire (Functional Assessment of Chronic Illness Therapy – Fatigue [FACIT‐F]) (0‐52). Data collected and analyzed included: demographic data, disease activity data, comorbidities and medications use. Results There were 231 eligible PsA patients recruited. The mean FACIT‐F score was 37.5 ± 9.1. Severe fatigue, defined as FACIT‐F score < 30, was found in 49 (22.1%) of them. The univariate model identified these associated factors of fatigue: tender and swollen joint count, dactylitis count, Psoriasis Area and Severity Index (PASI) score, pain and general health perception, Disease Activity in Psoriatic Arthritis (DAPSA) score, Health Assessment Questionnaire, the use of cyclosporine, sulphasalazine and biologic agents. The final regression model identified DAPSA and PASI were closely associated with severe fatigue (P = .003 and P = .04 respectively). No associations with fatigue were found between age, gender, disease duration, comorbidities and medication use. However, there were weak correlations between the magnitude of FACIT‐F score, DAPSA and PASI with r = −.3 and r = −.26 respectively. Conclusion Severe fatigue was common in PsA patients, and its magnitude was closely correlated with DAPSA and PASI score, indicating its multifactorial nature. Achieving DAPSA and PASI remission could significantly alleviate the fatigue intensity to a certain extent. However, treatment for PsA‐related fatigue should adopt a multidisciplinary approach in addition to disease activity control.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Fatigue in psoriatic arthritis: Is it related to disease activity?

Lai

Chung

et al. 2021

Int J of Rheum Dis

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“…Data was collected over a six-month period from January to June 2017 via rheumatology routine visits to Rigshospitalet—Glostrup and Frederiksberg. A detailed description of the methods of the study has previously been published [ 19 ].…”

Section: Methodsmentioning

confidence: 99%

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

Esbensen

Stallknecht²,

Madsen³

et al. 2020

PLoS ONE

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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.

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“…In a recent Danish study, 61% of the patients with RA reported having moderate to severe fatigue. 2 Fatigue was identified by patients with RA as an important patient-reported outcome measure (PROM) during the development of the RA Impact of Disease (RAID) 3 questionnaire. The aetiology of fatigue is multifactorial and is likely to be influenced both by disease-related inflammation, by pain, cognitive factors, depressive symptoms and personal issues in the individual patient’s life.…”

Section: Introductionmentioning

confidence: 99%

Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy

et al. 2020

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ObjectivesTo define fatigue trajectories in patients with rheumatoid arthritis (RA) who initiate biological DMARD (bDMARD) treatment, and explore baseline predictors for a trajectory of continued fatigue.MethodsOne-hundred and eighty-four patients with RA initiating bDMARDs were assessed at 0, 1, 2, 3, 6 and 12 months. Swollen and tender joint counts, patient reported outcomes (PROMs), blood samples and ultrasound examinations were collected at each time point. Fatigue was assessed by the fatigue Numeric Rating Scale (0–10) from the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire. Clinically significant fatigue was predefined as fatigue ≥4. Three trajectories of interest were defined according to level of RAID fatigue: no fatigue (≤3 at 5/6 visits), improved fatigue (≥4 at start, but ≤3 at follow-up) and continued fatigue (≥4 at 5/6 visits). Baseline variables were compared between groups by bivariate analyses, and logistic regression models were used to explore baseline predictors of continued vs improved fatigue.ResultsThe majority of patients starting bDMARD therapy followed one of three fatigue trajectories, (no fatigue; n=61, improved; n=33 and continued fatigue; n=53). Patients with continued fatigue were more likely to be anti–citrullinated protein antibody and/or rheumatoid factor positive and had higher baseline PROMs compared to the other groups, while there were no differences between the groups for variables of inflammation including. Patient global, tender joint count and anxiety were predictors for the continued fatigue trajectory.DiscussionA trajectory of continued fatigue was determined by PROMs and not by inflammatory RA disease activity.

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Severity of fatigue in people with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis – Results of a cross-sectional study

Cited by 27 publications

References 35 publications

Fatigue in psoriatic arthritis: Is it related to disease activity?

Fatigue in psoriatic arthritis: Is it related to disease activity?

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

Trajectories of fatigue in actively treated patients with established rheumatoid arthritis starting biologic DMARD therapy

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