Background/Purpose: Fatigue is omnipresent in patients with SLE. According to one study 80-90 % of the subjects report some degree of fatigue. This has huge impact on the patient’s activities of daily living and overall quality of life. The fatigue associated with SLE was traditionally considered to be a consequence of SLE disease activity and difficult to measure and quantify in clinical practice. Recent recommendations from several international rheumatology societies and patient advocacy groups have focused on improving quality of life by focusing on issues such as fatigue during clinical encounters with SLE patients. The goal of this study is to measure severity of fatigue in our SLE cohort and to identify any predictors of fatigue.

Methods: We administered a well validated tool of fatigue measure Fatigue Severity Scale (FSS) to consecutive, consenting SLE subjects during their routine outpatient visits at a tertiary care center. Their demographic data, lab values, comorbidities and current medications were recorded at the time of visit. A rheumatologist blinded to the patient FSS scores calculated the SELENA-SLEDAI and SLICC/ACR damage index scores. Statistical analysis using SAS Software (SAS Institute Inc. Cary, NC) was done to identify any predictive variables using multiple regression models and a stepwise multiple regression models.

Results: FSS was collected from 100 unique patients over a period of 9 months (Table 1). The majority of patients reported significant fatigue with minimal or no disease activity. FSS scores were unrelated to SLEDAI, disease duration, and plasma hemoglobin concentration (Table 2). FSS correlated significantly with SLICC/ACR (p=0.0123) and BMI (p=0.0337). Ethnicity, type of medications, comorbidities, and especially fibromyalgia, were found not to be predictive of fatigue in this cohort.

Conclusion: Results of this study suggest that organ damage accrual may be associated with the severity of fatigue in patients with SLE, independently of their disease activity or duration. Overall the results may implicate, in addition to aggressive early treatment to minimize damage accrual, lifestyle modification such as diet and increased physical activity to lower BMI as a potential therapeutic adjunct to improve fatigue in SLE.  

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/fatigue-in-patients-with-systemic-lupus-erythematosus-is-independent-of-their-disease-activity-but-dependent-on-their-damage-accrual-and-body-mass-index/