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Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: predictors and response to treatment.
Holten, Karen; Paulshus Sundlisater, Nina; Lillegraven, Siri; Sexton, Joseph; Nordberg, Lena Bugge; Moholt, Ellen; Hammer, Hilde Berner; Uhlig, Till; Kvien, Tore K; Haavardsholm, Espen A; Aga, Anna-Birgitte.
Afiliación
  • Holten K; Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway karenholten@gmail.com.
  • Paulshus Sundlisater N; Faculty of Medicine, University of Oslo, Oslo, Norway.
  • Lillegraven S; Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway.
  • Sexton J; Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway.
  • Nordberg LB; Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway.
  • Moholt E; Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway.
  • Hammer HB; Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway.
  • Uhlig T; Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway.
  • Kvien TK; Faculty of Medicine, University of Oslo, Oslo, Norway.
  • Haavardsholm EA; Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway.
  • Aga AB; Faculty of Medicine, University of Oslo, Oslo, Norway.
Ann Rheum Dis ; 81(3): 344-350, 2022 03.
Article en En | MEDLINE | ID: mdl-34389605
ABSTRACT

OBJECTIVES:

Fatigue is a frequent symptom in rheumatoid arthritis (RA) and has high impact on quality of life. We explored associations between disease activity and fatigue in patients with early RA during the initial 24 months of modern treat-to-target therapy and predictors of fatigue after 24 months of follow-up.

METHODS:

Data were obtained from the treat-to-target, tight control Aiming for Remission in Rheumatoid Arthritis a Randomised Trial Examining the Benefit of Ultrasound in a Clinical Tight Control Regime (ARCTIC) trial. Fatigue was measured on a visual analogue scale (VAS) from 0 to 100 mm and defined as clinically relevant if VAS was ≥20 mm. Baseline predictors of fatigue at 24 months were analysed by multivariable logistic regression.

RESULTS:

205 patients with fatigue data at baseline and 24 months were included. Median (25th, 75th percentiles) symptom duration was 5.4 months (2.8, 10.4), fatigue VAS 37.0 mm (13.0, 62.0) and mean Disease Activity Score (DAS) 3.4 (SD 1.1) at baseline. Prevalence of fatigue declined from 69% at baseline to 38% at 24 months. Fewer swollen joints (OR 0.92, 95% CI 0.87 to 0.98, p=0.006), lower power Doppler ultrasound score (OR 0.95, 95% CI 0.90 to 0.99, p=0.027) and higher patient global assessment (PGA) (OR 1.03, 95% CI 1.01 to 1.04, p<0.001) increased the risk of clinically relevant fatigue at 24 months. Not achieving remission at 6 months was associated with a higher risk of reporting fatigue at 24 months.

CONCLUSIONS:

Fatigue in patients with early RA was prevalent at disease onset, with a rapid and sustained reduction during treatment. Low objective disease activity and high PGA at baseline were predictors of clinically relevant fatigue at 24 months.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Artritis Reumatoide / Antirreumáticos / Fatiga Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Rheum Dis Año: 2022 Tipo del documento: Article País de afiliación: Noruega

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Artritis Reumatoide / Antirreumáticos / Fatiga Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Rheum Dis Año: 2022 Tipo del documento: Article País de afiliación: Noruega