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

BACKGROUND

Despite improvements in treatment for rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (axSpA), several key unmet needs remain, such as fatigue. The objective of this study was to describe the severity of fatigue, disease characteristics and socioeconomic factors in people with RA, PsA and axSpA.

METHODS

The study was designed as a cross-sectional survey collecting patient characteristics such as disease characteristics, socioeconomic factors and fatigue in people with RA, PsA and axSpA in Denmark. Respondents were consecutively recruited for the study over a six-month period in 2018 via routine visits to outpatient rheumatology clinics. Study nurses collected information on diagnosis, current disease-related treatment and disease activity from medical journals. People were invited to complete a questionnaire related to socioeconomic factors and containing the FACIT-Fatigue subscale. Descriptive statistics were analyzed using SAS.

RESULTS

We invited 633 people to participate, and 488 (77%) completed the questionnaire. Women constituted 62% of respondents, and the mean age was 53.5 years. Respondents had on average been diagnosed between 11 and 15 years ago. Overall, 79% had no changes to their disease-related treatment during the past year, and the average disease activity as indicated by DAS28 for RA and PsA was 2.48 and 2.36, respectively, and BASDAI for axSpA was 28.40. Fatigue was present in all three diagnoses (mean: 34.31). The mean fatigue score varied from respondents answering that they suffered from no or little fatigue (mean: 45.48) to extreme fatigue (mean: 10.11). Analyses demonstrated that the respondents were not considerably different from nonrespondents, and the study population is considered representative compared with Danish RA and axSpA patients in the Danish National Rheumatology Registry, the DANBIO database.

CONCLUSION

We found that the majority of the study population were fatigued (61%). They had low disease activity and few disease-related treatment changes.

Déclaration de conflit d'intérêts

We have read the journal's policy and the authors of this manuscript have the following competing interests: SES and HHJ report consultation fees from Pfizer Denmark during the conduct of the study and consultation fees from Pfizer Denmark outside the submitted work. SES and HHJ are employees of Incentive, which was a paid vendor of Pfizer Denmark and a commercial company. BAE is an employee of Rigshospitalet and University of Copenhagen and reports research grant for data collection and personal fees for lead investigator consultancy on the protocol development from the funder during the conduct of the study. In addition, BAE has received research grants and personal consultancy fees from the funder outside the submitted work. TP and LH are employees of Pfizer Denmark and reports salaries from Pfizer Denmark. There are no patents, products in development, or marketed products associated with this research to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.