Impact of fatigue on health-related quality of life and illness perception in a monocentric cohort of patients with systemic lupus erythematosus.


Journal

RMD open
ISSN: 2056-5933
Titre abrégé: RMD Open
Pays: England
ID NLM: 101662038

Informations de publication

Date de publication:
02 2020
Historique:
received: 27 10 2019
revised: 02 12 2019
accepted: 06 12 2019
entrez: 21 2 2020
pubmed: 23 2 2020
medline: 20 4 2021
Statut: ppublish

Résumé

Fatigue is a very common and debilitating symptom in patients with systemic lupus erythematosus (SLE), even among those with a mild or inactive disease. The objective of this study is to define fatigue determinants and describe the impact of fatigue on health-related quality of life (HRQoL) and illness perception in a monocentric cohort of patients with SLE. This is a cross-sectional study. Adult patients with SLE were included. For each patient, demographics, medications, comorbidities, organ damage (Systemic Lupus International Collaborating Clinics Damage Index), active disease manifestations and Systemic Lupus Disease Activity Index scores were collected. It was evaluated if each patient met the definitions of remission and low disease activity. At enrolment, each patient completed the Short Form-36 (SF-36), Functional Assessment Chronic Illness Therapy-Fatigue (FACIT-F), Lupus Impact Tracker (LIT), Systemic Lupus Activity Questionnaire (SLAQ) and Brief Index of Lupus Damage (BILD). The FACIT-F questionnaire was also administered to a group of healthy controls. 223 patients were included (mean age 44.9±13.2 years, median disease duration 13 years). 18.2% had an active disease, 43.5% met the definition of remission on treatment, and 11.8% had a concomitant fibromyalgia. The median FACIT-F score of our cohort was significantly lower compared with that of healthy controls (40 vs 47; p<0.001). FACIT-F scores were irrespective of age, disease duration, disease activity and damage. FACIT-F score was significantly lower in patients with fibromyalgia (p<0.01). FACIT-F scores demonstrated a significant correlation with all other patient-reported outcomes: SF-36 (r=0.53-0.77), LIT (r=-0.78), SLAQ (r=-0.72) and BILD (r=-0.28). Fatigue in patients with SLE has a strong negative impact on HRQoL and patient perception of the disease burden. Fatigue seems irrespective of disease activity but significantly influenced by the presence of fibromyalgia.

Sections du résumé

BACKGROUND
Fatigue is a very common and debilitating symptom in patients with systemic lupus erythematosus (SLE), even among those with a mild or inactive disease. The objective of this study is to define fatigue determinants and describe the impact of fatigue on health-related quality of life (HRQoL) and illness perception in a monocentric cohort of patients with SLE.
METHODS
This is a cross-sectional study. Adult patients with SLE were included. For each patient, demographics, medications, comorbidities, organ damage (Systemic Lupus International Collaborating Clinics Damage Index), active disease manifestations and Systemic Lupus Disease Activity Index scores were collected. It was evaluated if each patient met the definitions of remission and low disease activity. At enrolment, each patient completed the Short Form-36 (SF-36), Functional Assessment Chronic Illness Therapy-Fatigue (FACIT-F), Lupus Impact Tracker (LIT), Systemic Lupus Activity Questionnaire (SLAQ) and Brief Index of Lupus Damage (BILD). The FACIT-F questionnaire was also administered to a group of healthy controls.
RESULTS
223 patients were included (mean age 44.9±13.2 years, median disease duration 13 years). 18.2% had an active disease, 43.5% met the definition of remission on treatment, and 11.8% had a concomitant fibromyalgia. The median FACIT-F score of our cohort was significantly lower compared with that of healthy controls (40 vs 47; p<0.001). FACIT-F scores were irrespective of age, disease duration, disease activity and damage. FACIT-F score was significantly lower in patients with fibromyalgia (p<0.01). FACIT-F scores demonstrated a significant correlation with all other patient-reported outcomes: SF-36 (r=0.53-0.77), LIT (r=-0.78), SLAQ (r=-0.72) and BILD (r=-0.28).
CONCLUSIONS
Fatigue in patients with SLE has a strong negative impact on HRQoL and patient perception of the disease burden. Fatigue seems irrespective of disease activity but significantly influenced by the presence of fibromyalgia.

Identifiants

pubmed: 32075876
pii: rmdopen-2019-001133
doi: 10.1136/rmdopen-2019-001133
pmc: PMC7046978
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Elena Elefante (E)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.
Department of Medical Biotechnologies, University of Siena, Siena, Italy.

Chiara Tani (C)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Chiara Stagnaro (C)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Francesco Ferro (F)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Alice Parma (A)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Linda Carli (L)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Viola Signorini (V)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Dina Zucchi (D)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Umberto Peta (U)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Adele Santoni (A)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Leonardo Raffaelli (L)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Marta Mosca (M)

Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy marta.mosca@med.unipi.it.

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