Background/Purpose: Fatigue is a common clinical feature in patients with primary Sjögren’s syndrome (pSS). Objectives of this study were to assess major determinants contributing to fatigue development in a multicenter cohort of patients with pSS and to explore the impact of fatigue on pSS patients treatment in real-life.

Methods: This multicenter cross-sectional involved five Italian reference centers with substantial experience in the management of pSS. We included 360 pSS patients (AECG criteria) seen consecutively. A standardized data set including demographic, clinical and serological disease manifestations and patients’ treatment was collected prospectively. The ESSDAI and the SSDDI were used to assess disease activity and organ damage, respectively. Fatigue was assessed according to the fatigue VAS scale of the ESSPRI. Multiple linear regression analysis was used to estimate the effect of each variable on fatigue severity.

Results: We enrolled 360 pSS patients (346 F:14 M); mean age(S.D.) at study inclusion was 58(15)yrs, mean disease duration (S.D.) was 6(7)yrs. Seventy-eight percent of patients (280/360) reported a fatigue score >5. Fatigue VAS scores correlated significantly with the other scales of the ESSPRI (i.e. Spearman r ranging from 0.49 to 0.62) and weakly with the ESSDAI (Spearman r= 0.12, p=0.03). No association was found between fatigue VAS scores and patients’ demographics (i.e age at study inclusion, disease duration). In addition we did not find any association between fatigue and patients’ serological/biological profile. Fatigue VAS scores were significantly higher in patients presenting inflammatory arthralgias (p=0.02) and fibromyalgia (p=0.000). At multivariate analysis fatigue severity was independently associated with fibromyalgia [OR (95%IC)=2.29 (1.24-4.22)] and arthralgias [OR (95%IC)=1.79 (1.01-3.17)] . Regarding the impact of fatigue on patients’ therapy we found that fatigue VAS scores were significantly higher in patients assuming corticosteroids (p=0.006) and hydroxychloroquine (p=0.001) and that in patients with a fatigue score >5 the prevalence of patients assuming only symptomatic drugs was significantly lower with respect to patients with a less severe fatigue (29.4% vs 45.3%, p=0.01).

Conclusion: In our study, arthralgias and fibromyalgia were the most significant determinants of fatigue in pSS. Fatigue may influence medical prescription of steroids and hydroxychlorochine in pSS in real life.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/determinants-of-fatigue-in-patients-with-primary-sjogrens-syndrome-and-impact-of-fatigue-on-patients-treatments-a-cohort-study/