ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 1602

Fatigue in Systemic Lupus: The Role of Disease Activity and Its Mediators

Desiree R Azizoddin1, Meenakshi Jolly2, Joel A. Block3 and Perry M. Nicassio4, 1Department of Medicine and Behavioral Sciences, Rush University, Chicago, IL, 2Rush, Chicago, IL, 3Division of Rheumatology, Rush University Medical Center, Chicago, IL, 4Cousins Center for PNI, UCLA, LA, CA

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: depression, Fatigue, pain, stress and systemic lupus erythematosus (SLE)

  • Tweet
  • Email
  • Print
Session Information

Date: Monday, November 6, 2017

Session Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment Poster II: Damage and Comorbidities

Session Type: ACR Poster Session B

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

Background/Purpose: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that leads to a variety of negative health outcomes. Though treatment continues to advance, fatigue remains one of the most salient, unaddressed patient complaints. Understanding the mechanisms of fatigue can help guide the development of interventions to improve health outcomes. The aim was to evaluate the role of six variables (disease activity, insomnia, depression, stress, pain, and physical functioning) towards fatigue in individuals with SLE.

Methods: 116 ethnically-diverse, primarily female participants (91%) with SLE, receiving care at university medical centers, completed assessments of disease activity, and quality of life outcomes (FACIT-FT, Insomnia Severity Index, Perceived Stress Scale (PSS-4), Pain Inventory, Depression-PHQ-9, and LupusPRO-physical function). All patients met ACR classification criteria for SLE and did not have concurrent diagnosis of fibromyalgia. Multivariate linear and stepwise regression analyses were conducted with fatigue (FACIT-FT) as the dependent variable and above six variables as independent variables.

Results:

Mean(SD) age was 39.80(13.9) years; 50% were African American, 21% Caucasian, 13% Hispanic, 9% Asian, and 8% other. Mean(SD) FACIT-FT was 18.6(11.8). Collectively, these six variables explained 57% variance in fatigue; wherein depression, stress and pain were significant independent predictors of fatigue on the multivariate model, but not disease activity, sleep or physical health. Largest magnitude of effect on fatigue was with stress (β 0.77, 95% CI0.17, 1.38, p=0.01) followed by depression (β 0.66, 95% CI0.21, 1.10, p=0.005). On stepwise regression analysis, stress, depression and pain collectively explained 56% of variance in fatigue in SLE. All three were independent correlates of fatigue, and the largest contribution to fatigue was again from stress (β0.84,95% CI 0.27,1.42, P=0.005), followed by depression (β0.79, 95% CI 0.44,1.14, p=<0.001).

Conclusion:

Stress and depression are the largest and independent contributors to fatigue among patients with SLE without concurrent fibromyalgia. Disease activity, sleep and physical health were not associated with fatigue in patients with SLE without concurrent fibromyalgia. Evaluation of stress and depression needs to be incorporated during assessment of SLE patients, especially in context of fatigue. This stress-depression-fatigue model needs further validation in a longitudinal study

Table 1. Demographics and general characteristics (n=116)

M SD n %

Female

105

(90.5)

Age (years)

39.80

(13.87)

Ethnicity

African American

58

(50.0)

Caucasian

24

(20.7)

Hispanic

15

(12.9)

Asian

10

(8.6)

Other

9

(7.8)

Marital Status

Single

61

(52.6)

Married/lives with partner

27

(23.3)

Divorced

7

(6.0)

Widowed

1

(0.9)

Not reported

4

(3.4)

Education level

Less than high school

5

(4.3)

High school

37

(31.9)

College/University degree

56

(48.6)

Graduate degree

12

(10.3)

Employment

Unemployed

11

(9.5)

Work part-time

12

(10.3)

Work full-time

44

(37.9)

Homemaker

7

(6.0)

Student

4

(3.4)

On disability

27

(23.3)

Retired

5

(4.3)

Not available

4

(3.4)

# of ACR Criteria met

5.00

(4.15)

PGA

0.59

(0.51)

SDI

0.64

(1.03)

Prednisone

Active use

77

(62.4)

dose (mg/day)

11.362

(15.17)

Disease duration (years)

8.69

(7.21)

Note. SDI: SLICC/ACR Damage Index. SS: SELENA-SLEDAI. PGA: Physician Global Assessment

Table 2. Regression analyses models for fatigue

Multivariate Model

Hierarchical Model

R2

β

95% CI

P

R2

β

95% CI

P

Disease Activity

0.57

-0.03

-0.47,0.41

0.890

0.56

Stress

0.77

0.17,1.38

0.010

0.84

0.26,1.42

0.005

Depression

0.66

0.21,1.10

0.005

0.79

0.44,1.14

0.0001

Pain

0.22

0.10,0.43

0.040

0.27

0.10,0.43

0.002

Sleep

0.16

-0.20,0.52

0.390

Physical Health

-0.03

-0.13,0.07

0.560


Disclosure: D. R. Azizoddin, None; M. Jolly, Pfizer Inc, 2,Medimmune, celgene, boehringer ingelheim, aurinia,, 7; J. A. Block, None; P. M. Nicassio, None.

To cite this abstract in AMA style:

Azizoddin DR, Jolly M, Block JA, Nicassio PM. Fatigue in Systemic Lupus: The Role of Disease Activity and Its Mediators [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/fatigue-in-systemic-lupus-the-role-of-disease-activity-and-its-mediators/. Accessed January 27, 2023.
  • Tweet
  • Email
  • Print

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/fatigue-in-systemic-lupus-the-role-of-disease-activity-and-its-mediators/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences