Background/Purpose: to determine and characterize fatigue trajectories over 10 years of follow-up in a cohort of early RA patients.

Methods: We selected patients fulfilling the 2010 ACR/EULAR criteria for RA included in the ESPOIR cohort. Cluster analysis with Ward’s method was used to obtain fatigue trajectories over the course of 10 years from enrolment. To evaluate differences between baseline variables and fatigue trajectories, Chi-square analyses and ANOVA were used. A multivariate linear regression model with repeated measures was developed to determine the relationship between score of fatigue and other variables over 10 years of follow-up.

Results: We analysed 598 patients. Cluster analysis revealed 3 trajectories: high (18%), moderate (52%) and low fatigue (30%). At baseline, patients with high fatigue trajectory reported significantly higher duration and intensity of morning stiffness, higher HAQ score, higher number of tender joints, higher levels of pain, higher number of awakenings due to arthritis, higher DAS28 levels, increased psychological distress and higher levels of physician and patient global assessment than patients with moderate or low fatigue trajectory (Table 1).

The multivariate linear regression mixed model confirmed that young age, increased psychological distress, high pain level, high morning stiffness intensity, high levels of patient and physician global assessment were related to high levels of fatigue over time (Table 2).

Conclusion: Baseline clinical measures and baseline patient-reported measures of functional status better distinguished the three fatigue trajectories. We did not find differences between trajectories in baseline laboratory measures. Patients with higher levels of pain, psychological distress, morning stiffness intensity also experienced more severe fatigue over time.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/patterns-of-fatigue-in-early-ra-over-10-years-results-from-the-espoir-cohort/