Fatigue in Primary Sjögren's Syndrome: Clinical, Laboratory, Psychometric and Biological Associations

Theofanis Karageorgas¹, Sofia Fragkioudaki², Adrianos Nezos³, Dimitris Karaiskos⁴, Clio Mavragani⁵ and Haralampos M. Moutsopoulos⁶, ¹Clinical Immunology and Rheumatology, "Attikon" University Hospital of Athens, Athens, Greece, ²Physiology, Medical School of Athens, Department of Physiology, Athens, Greece, ³Physiology, Department of Experimental Physiology, School of Medicine, National Kapodistrian University of Athens, Athens, Greece, ⁴Physiology, School of Medicine, University of Athens, Athens, Greece, Athens, Greece, ⁵Physiology, Department of Physiology, School of Medicine, National Kapodistrian University of Athens, Athens, Greece, ⁶Department of Pathophysiology, Medical School of Athens, Department of Pathophysiology, Athens, Greece

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: fatigue and interferons, Sjogren's syndrome

Session Information

Date: Tuesday, November 10, 2015

Title: Sjögren's Syndrome: Translational Insights into Sjögren's Syndrome

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: To identify independent predictors of fatigue in primary Sjogren’s Syndrome (pSS) patients taking into account clinical, laboratory and psychological features and to explore the potential role of interferon (IFN)-induced gene indoleamine 2,3-dioxygenase (IDO-1), anti-21 hydroxylase [anti-21(OH)] antibodies and soluble B-cell activating factor (sBAFF).

Methods: Detailed clinical and laboratory characteristics were recorded for 106 pSS patients. FACIT-F, Zung Depression Scale, State-Trait Anxiety Inventory, Eysenck Personality Questionnaire Scale and Athens Insomnia Scale were adopted to assess fatigue, depression, anxiety and sleep disturbances respectively. Peripheral whole blood expression levels of IDO-1, as well as type I and II IFN-induced genes were calculated using qRT-PCR. Serum anti-21(OH) antibodies and sBAFF levels were determined by a radioimmunoassay and an ELISA, respectively. Univariate and multivariate models were performed to identify determinants of fatigue.

Results: Fatigue was detected in 32 out of 106 (30.2%) of pSS patients. In univariate analysis, fatigue was associated with arthralgias/myalgias, hydroxychloroquine therapy, both state and trait anxiety scores, depression and neuroticism, as well as impaired sleep patterns. Multivariate analysis revealed neuroticism [OR=6.0 (95%CI:1.5-23.8)], depression [OR=3.4 (95%CI:1.0-12.2)] and state anxiety [OR=3.0 (95%CI:0.9-10.6), as independent predictors of fatigue. sBAFF levels, anti-21(OH) autoantibodies and IDO-1 mRNA expression did not significantly differ between fatigued and non-fatigued pSS patients.

Conclusion: Depression, anxiety and neuroticism play a major role in pSS-associated fatigue and should be addressed, in clinical practice, with active collaboration between rheumatologists and mental health professionals. Further studies are warranted in order to explore underlying pathophysiological pathways that might explain fatigue in the setting of pSS.

Disclosure: T. Karageorgas, None; S. Fragkioudaki, None; A. Nezos, None; D. Karaiskos, None; C. Mavragani, None; H. M. Moutsopoulos, None.

To cite this abstract in AMA style:

Karageorgas T, Fragkioudaki S, Nezos A, Karaiskos D, Mavragani C, Moutsopoulos HM. Fatigue in Primary Sjögren’s Syndrome: Clinical, Laboratory, Psychometric and Biological Associations [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/fatigue-in-primary-sjogrens-syndrome-clinical-laboratory-psychometric-and-biological-associations/. Accessed .

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